Growth differentiation factor 15 as an integral marker of the clinical and functional status of patients with non-valvular atrial fibrillation

Abstract

Aim. To study the relationship between growth differentiation factor 15 (GDF-15) level in blood serum and patient clinical and functional status parameters, and to determine predictors of GDF-15 level in pts with non-valvular atrial fibrillation (AF).Material and methods. Eighty-seven pts (with the mean age of 56.9±9.2 years) with non-valvular AF were studied. A general clinical examination, as well as echocardiography and laboratory tests were performed. These included fasting serum glucose (mmol/l), highly sensitive C-reactive protein (h/s CRP) (mg/l), creatinine level (μmol/l) and subsequent calculation of glomerular filtration rate (ml/min/1.73m2), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) (pg/ml). The level of GDF-15 (pg/ml) in blood serum was determined using an enzyme immunoassay with a human ELISA analytical kit.Results. An increase in GDF-15 level was associated with age, ischemic heart disease, severity of hypertension, and heart failure, resulting in a higher risk of stroke, according to the CHA2DS2 -VASc score, carbohydrate metabolism disorders and obesity, increased h/s CRP and NT-proBNP levels, enlargement of the right and left atria, signs of diastolic left ventricular dysfunction and structural remodeling in the form of eccentric hypertrophy. Multiple linear regression analysis revealed 2 independent predictors of GDF-15 levels: age and fasting glucose.Conclusion. GDF-15 is an integral biomarker of age-related metabolic disorders and structural and functional changes in the heart, which opens up prospects for further study of its prognostic significance in pts with non-valvular AF.