Growth-Differentiation Factor-15 as Additional Prognostic Biomarkers in Heart Failure

Abstract

Heart Failure (HF) remains to be a leading factor of cardiovascular morbidity and mortality. Although risk stratification of HF is promising prediction care, there are several controversies regarding choosing more optimal combinations of biomarkers and method (single versus serial measurements) of biomarker use in routine clinical practice. Growth differentiation factor-15 (GDF-15) is considered a biomarker associated with cardiac/vascular remodeling, oxidative stress, fibrosis and inflammation that were proposed to stratify HF patients at risk of death. It has been suggested that GDF-15 adding to natriuretic peptides or other conventional biomarkers (soluble ST2, cardiac troponins and galectin-3) might improve discriminative value of entire predictive models. The short communication is depicted the discussion about the perspectives of clinical use of GDF-15 in risk stratification of HF.

Growth Differentiation Factor 15 As Promising Biomarker Of Poor Prognosis In Heart Failure

“…The HF-ACTION (Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training) study was yielded that GDF-15 in plasma positively associated with severity of HF, peak concentration of NT-proBNP, all-cause death rate and inversely related to peak oxygen uptake on cardiopulmonary exercise testing [21] . Interestingly, the serum levels of GDF-15 in patients with HFpEF were similar to those in HFrEF, while it associated with the severity of HF symptoms, echocardiographic parameters of LV dysfunction, 6 minute walk test distance and SF-36 physical score [33,34] . However, in HFpEF GDF-15 did not improve diagnostic discrimination when it is added to clinical status, cardiopulmonary exercise test findings…”

Promising utilities of growth differentiation factor 15 in cardiovascular diseases

“…Interestingly, in the study the serum levels of GDF-15 in chronic HF patients with preserved left ventricular (LV) ejection fraction (EF) were similar to those in reduced LVEF (HFrEF), while it associated with the severity of HF symptoms, echocardiographic parameters of LV dysfunction, 6 minute walk test distance and SF-36 physical score [26]. However, in chronic HF with preserved LVEF (HFpEF) GDF-15 did not improve diagnostic discrimination when it is added to clinical status, cardiopulmonary exercise test findings and traditional biomarkers including high sensitive troponin T, galectin-3, soluble ST2 and NT-proBNP [27]. In contrast, in HFrEF diagnostic accuracy of GDF-15 was not inferior as that of NT-proBNP and combining both biomarkers may improve diagnostic discrimination [28].…”