BACKGROUND: 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: 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.
BACKGROUND: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: 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.
Authors: George K Lui; Ian S Rogers; Victoria Y Ding; Haley K Hedlin; Kirstie MacMillen; David J Maron; Christy Sillman; Anitra Romfh; Tara C Dade; Christiane Haeffele; Stafford R Grady; Doff B McElhinney; Daniel J Murphy; Susan M Fernandes Journal: Am J Cardiol Date: 2016-09-30 Impact factor: 2.778
Authors: Laurie W Geenen; Roderick W J van Grootel; Korhan Akman; Vivan J M Baggen; Myrthe E Menting; Jannet A Eindhoven; Judith A A E Cuypers; Eric Boersma; Annemien E van den Bosch; Jolien W Roos-Hesselink Journal: J Am Heart Assoc Date: 2019-08-21 Impact factor: 5.501
Authors: Sophie L Meyer; Djoeke Wolff; Floris-Jan S Ridderbos; Graziella Eshuis; Hans Hillege; Tineke P Willems; Tjark Ebels; Joost P van Melle; Rolf M F Berger Journal: J Am Heart Assoc Date: 2020-05-08 Impact factor: 5.501
Authors: Eva van den Bosch; Sjoerd S M Bossers; Vivian P Kamphuis; Eric Boersma; Jolien W Roos-Hesselink; Johannes M P J Breur; Arend D J Ten Harkel; Livia Kapusta; Beatrijs Bartelds; Arno A W Roest; Irene M Kuipers; Nico A Blom; Laurens P Koopman; Willem A Helbing Journal: J Am Heart Assoc Date: 2021-02-24 Impact factor: 5.501