The Value Of Growth-differentiation Factor-15for Clinical Diagnostic In Patients With Chronic Heart Failure

Objectives:The aims were to evaluate plasma levels of growth-differentiation factor-15(GDF-15) in study subjects with chronic heart failure, discuss the diagnosis significance of GDF-15and analyze clinical factors affecting GDF-15level, and provide more specific biochemical markers, screen the high-risk groups and take medical attention and early intervention treatment.Methods:There were168subjects enrolled in this study.The subjects were divided into two groups, experimental group patients (n=130) with chronic heart failure (NYHA Ⅰ-Ⅳ) and control group (n=38) with atrioventricular reentry tachycardia(AVRT) history or no history of any diseases.Detailed medical history, and demographic characteristics were recorded. Electrocardiogram, chest radiography and echocardiogram, blood cell analysis,biochemistry routine, Hs-CRP, Hs-TNT and NT-Pro BNP were performed. ELISA method was used to detect the plasm levels of GDF-15in the two groups. The patients with chronic heart failure were subdivided into heart failure compensatory group (NYHA Ⅰ, Ⅱ level)(n=72) and heart failure decompensatory group (NYHA Ⅲ,Ⅳlevel)(n=58) by New York Heart Association; subdivided into ischemic congestive heart failure group (n=95) and non-ischemic congestive heart failure group (n=35) by underlying disease type; and subdivided into LVEF<50%(n=40) and LVEF≥50%(n=90) by left ventricular ejection fraction level.Results:1. In the two groups, the levels of GDF-15in experimental group were significantly higher than those in control group (P<0.05).2. In subgroup analysis, the levels of GDF-15in ischemic heart failure group and non-ischemic heart failure group were of no difference, and GDF-15levels in patients with LVEF≥50%group and LVEF<50%group also were of no difference.3. The plasma GDF-15levels increase along with grading.of NYHA.GDF-15levels in contorl group, heart failure compensatory group (NYHA Ⅰ,Ⅱ level) and heart failure decompensatory group (NYHA Ⅲ, Ⅳ level) increase gradually, which were130.01±29.59ng/L,140.22±29.78ng/L,and149.33±26.20ng/L,respectively (P<0.05).4. Pearson analysis showedNT-Pro BNP and NYHA level have positive correlation with GDF-15(r=0.19,0.185, P<0.05) and LVEF have negative correlation with GDF-15level (r=-0.36, P<0.05)Conclusions:1. The GDF-15level s of chronic heart failure were significantly higher those of control group. GDF-15have the potential to be the heart failure biomarker. 2. There was no statistics difference of GDF-15level between ischemic heart failure group and non-ischemic heart failure group, LVEF≥50%and LVEF<50%, with diabetes and non-diabetes.3. The plasma GDF-15levels increase along with NYHA grading The levels of GDF-15may distinguish severity of heart failure.