The Diagnostic And Prognostic Value Of Hepatocyte Growth Factor And Growth Differentiation Factor-15 In The Patients With Chronic Heart Failure

Purpose To investigate the diagnostic and prognostic value of the levels of serum hepatocyte growth factor(HGF)and growth differentiation factor-15(GDF-15)in the patients with chronic heart failure(CHF).Methods One hundred and fifty CHF patients were selected as the CHF group.According to the New York Heart Association(NYHA)classification of cardiac function,the CHF group was divided into three groups,including NYHA II subgroup,NYHA III subgroup,NYHA IV subgroup.And according to the underlying disease type,the CHF group was divided into two groups,including ischemic heart failure(IHF)subgroup,non-ischemic heart failure(NIHF)subgroup.Twenty eight healthy people were selected as the control group.Serum HGF and GDF-15 levels were detected by ELISA.Brain natriuretic peptide(BNP)level was detected in hospital.Left ventricular ejection fraction(LVEF)and left ventricular end-diastolic diameter(LVEDd)were detected by echocardiography.The CHF group patients were followed up for 6 months and CHF adverse events were recorded.And the mean survival years was calculated using the Seattle Heart Failure Model(SHFM).Results Compared with the normal group,the serum levels of HGF,GDF-15,BNP and LVEDd were significantly higher and LVEF were lower in the CHF group(P<0.05).Furthermore,the HGF and GDF-15 levels increase along with NYHA functional classification(P<0.05).Compared with NIHF group,the serum levels of HGF significantly were higher in IHF group.The levels of serum HGF and GDF-15 were positively correlated with BNP,LVEDd and NYHA functional classifications(r=0.47,0.34,0.42,0.33,0.85,0.74,P<0.05),and negatively correlated with LVEF and SHFM survival years(r=-0.49,-0.45,-0.27,-0.30,P<0.05).The ROC curve showed that the AUC of,HGF and GDF-15 in diagnosis of CHF were 0.886 and 0.862.The combined AUC was 0.891.The ROC curve showed that the AUC of BNP in diagnosis of CHF was 0.866.The combined AUC of HGF,GDF-15,and BNP was 0.898(P<0.05).The AUC of HGF and GDF-15 in diagnosis of IHF and NIHF were 0.757,0.458(P<0.05).The AUC of HGF and GDF-15 in predicting CHF adverse events were 0.843 and 0.817,and the combined AUC was 0.873.The AUC of BNP in predicting CHF adverse events was 0.815.The combined AUC of HGF,GDF-15 and BNP was 0.911(P<0.05).The AUC of serum HGF and GDF-15 in predicting CHF adverse events in IHF and NIHF groups were 0.806,0.488,0.481,and 0.429(P<0.05).Conclusion The levels of serum HGF and GDF-15 in patients with CHF were significantly higher,suggesting that deterioration of cardiac function and poor clinical prognosis.The level of serum HGF were significantly higher in IHF group,suggesting a certain value for the differential diagnosis of basic heart disease in CHF patients.Combination of multiple indicators can improve the value of diagnosis and prediction of CHF.It is suggested that serum HGF is valuable for the differential diagnosis of basic heart disease in CHF patients.