The Correlation Between Serum Level Of GDF-15with Chronic Heart Failure And Perindopril Treatment

Objective To investigate the effect of perindopril on serum level of GDF-15in chronic heart failure patiens and the relations to patient’s condition.Methods Fifty-nine chronic heart failure patien (HF, n=19) were randomly divided into two groups:low dose perindopril group (LP, n=39):routine anti-heart failure treatment and administered perindopril4mg/d treatment; hight dose perindopril group (HP, n=40):routine anti-heart failure treatment and administered perindopril8～10mg/d treatment; both groups were treated for six months. Moreover, selected forty patients that only have cardiovascular risk factors for control group (C, n=40). ELISA and immune nephelometry were applied in detecting the level of serum GDF-15and NT-proBNP before and after treatment, analized the relation between GDF-15and NT-proBNP, NYHA classification, echocardiogram parameter.Results First, in group C and group HF, the level of GDF-15was478.9(372.6,628.1)pg/ml,1276.1(712.2,1809.7)pg/ml; the level of NT-proBN P was86.1(71.7,112.1)pg/ml,1281.7(430.4,3725.7)pg/ml; both were signi ficantly higher in group HF than in group C(P<0.01). Second, the level of GDF-15and NT-proBNP in the NYHA classification I was619.2(543.7,1163.21) pg/ml and378.2(213.9,454.5) pg/ml, in the classification II was959.4(703.9,1325.6) pg/ml and546.6(417.8,1350.1)pg/ml, in the classificat ion III was1351.9(897.9,1909.8) pg/ml and2464.2(997.0,3210.1) pg/ml, in the classification IV was1764.9(1451.0,2202.2) pg/ml and5897.9(4562.3,11627.6) pg/ml; the level was increased fallow the NYHA classification (P<0.01). Third, the level of GDF-15and NT-proBNP in the heart failure sta ge A was478.9(372.6,695.6)pg/ml and86.1(71.7,112.1) pg/ml, in the stag e B was619.2(543.7,1163.2) pg/ml and378.2(213.9,454.5) pg/ml, in the st age C was1277.1(875.3,1721.3) pg/ml and1360.8(502.7,3224.9) pg/ml, in the stage D was2259.6(2144.4,2969.3)pg/ml and16900.2(9183.8,20057.0) pg/ml, the level was increased fallow the stages development. Fouth, the1evel of GDF-15have positive correlation with NT-proBNP (r=0.903, P=0.000), NYHA classification (r=0.636, P=0.000), LvEDd (r=0.806, P=0.000); and have negative correlation with LvEF (r=-0.704, P=0.000). Fifth, af ter the treament, in the group LP and HP, and the level of GDF-15and NT-proBNP were decreased (P<0.01); the level in group HP were significa nt decreased than in group LP(P<0.01).Conclusions The level of GDF-15in chronic heart failure patien was significantly increased; there were greatly relations between GDF-15and NT-proBNP or heart functional index, GDF-15have the strongest correlation with NT-proBNP; perindopril can improve heart functional and significantly decrease the level of GDF-15, show GDF-15may to be a new biomarker of heart failure, helpful to evaluate therapeutic effect and prognosis.