Release of growth-differentiation factor 15 and associations with cardiac function in adult patients with congenital heart disease

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• 作者：J.A. Eindhoven^a ; ¹ ; A.E. van den Bosch^a ; ¹ ; R.M. Oemrawsingh^a ; ¹ ; V.J. Baggen^a ; ¹ ; I. Kardys^a ; ¹ ; J.A. Cuypers^a ; ¹ ; M. Witsenburg^a ; ¹ ; R.H. van Schaik^b ; ¹ ; J.W. Roos-Hesselink^a ; ¹ ; ^{j.roos@erasmusmc.nl" class="auth_mail" title="E-mail the corresponding author} ; E. Boersma^a ; ¹
• 关键词：Adult congenital heart disease ; Growth differentiation factor 15 ; Ventricular function ; Echocardiography
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：1 January 2016
• 年：2016
• 卷：202
• 期：Complete
• 页码：246-251
• 全文大小：531 K

文摘

Growth-differentiation factor-15 (GDF-15), a cytokine with broad cardiac and non-cardiac activity, has diagnostic and prognostic value in various diseases, including heart failure. We aimed to investigate the release of GDF-15 in adults with congenital heart disease (ConHD), and assess the association with cardiac function and functional capacity.

Methods

A total of 587 consecutive adults with ConHD (median age 33 [IQR 25–41] years, 59% men, and 90% NYHA I) underwent electrocardiography, echocardiography, venepuncture and were seen by a cardiologist. A subset of 143 patients underwent bicycle ergometry on the same day.

Results

15">Median plasma GDF-15 was 618 [IQR 487–867] ng/L. In 87 patients (15%), GDF-15 was above the reference value of normal (1109 ng/L). GDF-15 levels were higher in older patients (r= 0.367, p<0.001). GDF-15 was higher in patients with elevated pulmonary pressure (median 1114 [IQR 796–2320 ng/L) than in patients with normal pulmonary pressure (median 606 [IQR 481–826] ng/L, p< 0.001). GDF-15 correlated positively with NT-proBNP (r= 0.445, p< 0.001). In multivariate analysis adjusting for age, sex, and NT-proBNP, hs-TnT and hs-CRP, GDF-15 above the reference value was associated with NYHA class (odds ratio for NYHA≥II: 3.5 [95% CI 1.8–6.8], p< 0.001), and decreased exercise capacity (odds ratio for workload > 85%:0.2 [95% CI 0.06–0.8], p= 0.018), but not with systolic ventricular function or ECG rhythm.

Conclusions

GDF-15 is elevated in a substantial number of patients and higher in those with elevated pulmonary pressures, regardless of underlying congenital diagnosis. GDF-15 is associated with NYHA class, NT-proBNP and exercise capacity, suggesting the marker has diagnostic and potential prognostic value in adults with ConHD.