Plasma Growth Differentiation Factor-15 in Children with Pulmonary Hypertension Associated with Congenital Heart Disease

Abstract

Objectives: We aimed to investigate the levels and diagnostic value of plasma growth differentiation factor15 (GDF-15) in children with pulmonary hypertension associated with congenital heart disease (PH-CHD). Methods: One hundred infants and children with CHD were included in the study; 50 of them with PHCHD and another 50 patients with CHD only. Fifty healthy infants and children of matched age and sex were included as a control group. GDF-15 levels as well as echocardiographic examination were done for all included subjects. Cardiac catheterization was performed for patients only. Results: GDF-15 levels were significantly higher in patients with PH-CHD (0.62±0.2) nmol/ml compared to those with CHD only patients (0.21±0.06) nmol/ml and to control group (0.13±0.02) nmol/ml with P<0.001. GDF-15 levels were significantly elevated according to the severity of PH; (0.4±0.1) nmol/ml in mild PH vs (0.7±0.3) nmol/ml in moderate PH vs (1.1±0.1) nmol/ml in severe PH. At a cutoff value of ≥ 0.313 nmol/ml, the sensitivity of GDF-15 as a diagnostic biomarker in PH-CHD children was 95%, the specificity was 100%, positive predictive value (PPV) was 100%, and negative predictive value (NPV) was 95.2 %. Conclusion: GDF-15 is elevated in infants and children with PH-CHD and can be a promising diagnostic biomarker in these patients.