Levels and diagnostic value of GDF-15, ST-2 and NT-proBNP in heart failure patients with different left ventricular ejection fraction
Wang Run
Cao Gaozhen
Lin Qingshan
Abstract：To discuss the expressions and clinical value of growth differentiation factor-15 (GDF-15), suppression of tumorigenicity-2 (ST-2) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with heart failure with preserved ejection fraction (HFpEF) or heart failure with reduced ejection fraction (HFrEF). Methods The patients (n=267) were chosen from Department of Cardiology in Shenzhen Hospital of University of Hong Kong from Feb. 2016 to Feb. 2018. All patients were divided, according to results of echocardiogram at hospitalization time, into HFpEF group (n=118) and HF-REF group (n=149). The levels of blood sugar, total cholesterol (TC), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C) and glycated hemoglobin (HbAlc) were detected in 2 groups. The content of GDF-15 and ST-2 were detected by using ELISA, and level of NT-proBNP was detected by using electro-chemiluminescence immunoassay (ECLIA). The left ventricular ejection fraction (LVEF), left atrial diameter (LAD), left ventricular end-diastolic inner diameter (LVEDd) and peak E mitral blood flow velocity/peak A mitral blood flow velocity (MVE/MVA) were recorded by using color Doppler ultrasonography. The diagnostic value of GDF-15, ST-2 and NT-proBNP to HFpEF was analyzed by using receiver operating characteristic (ROC) curve. Results ①The difference in indexes of blood sugar and blood fat had no statistical significance between 2 groups (all P>0.05) at hospitalization time. The levels of GDF-15, ST-2 and NT-proBNP were lower in HFpEF group than those in HFrEF group (P<0.05). ②LVEF was higher and other heart function indexes were lower in HFpEF group than those in HFrEF group (P<0.05). ③The results of multi-factor Logistic regression analysis showed that age, sex, GDF-15, ST-2, NT-proBNP and LVEF were independent impacting factors of (P<0.05). ④The results of ROC curve analysis showed that the area under ROC curve, sensitivity and specificity of integrated GDF-15, ST-2 and NT-proBNP in diagnosis were significantly higher than those of single diagnostic index (χ2=11.355, P<0.05). Conclusion The levels of GDF-15, ST-2 and NT-proBNP are closely correlated to LVEF, and they can be used as predictive factors in HFpEF patients.
Keywords：Growth differentiation factor-15Suppression of tumorigenicity-2N-terminal pro-brain natriuretic peptideHeart failurePredictive indexes
Publication Date：2019-01-01
Pages：5( 67-70,74 )