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Diagnosis Value of Plasma Growth Differentiation Factor-15 for Chronic Heart Failure

Author: CaiZongQun
Tutor: LiuShiMing
School: Guangzhou Medical College
Course: Department of Cardiology
Keywords: Growth Differentiation Factor 15 Brain natriuretic peptide Chronic heart failure
CLC: R541.6
Type: Master's thesis
Year: 2011
Downloads: 24
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Abstract

Background Chronic heart failure (chronic heart failure, CHF) is the end stage of heart disease due to a variety of causes. But so far, the therapeutic effect of heart failure is still not ideal, mortality remains high. Once the diagnosis of heart failure readmission rate, and the prognosis is poor. CHF early diagnosis and diagnosis to treatment and prognosis. Heart failure early signs and symptoms of the patient's lack of specificity, a simple, rapid and accurate diagnosis has important clinical significance, but existing diagnostic means fail to meet this requirement. Brain natriuretic peptide (brain natriuretic peptide, BNP) is to use the best of heart failure biomarker, but influenced by many factors, plasma BNP levels could not be used to confirm or exclude the diagnosis of heart failure, and therefore continue to look for other valuable markers of heart failure has important significance. Studies have shown that the growth and differentiation factor -15 (growth-differentiation factor-15, GDF-15) associated with cardiovascular disease, heart protection factor. Less study of the relationship of GDF-15 with heart failure. [Objective] To explore the value of GDF-15 plasma levels in the diagnosis of chronic heart failure compared with BNP. [Methods] during the period from November 2009 to September 2010, the Second Affiliated Hospital of Guangzhou Medical College Department of Cardiology hospital diagnosed 110 patients with chronic heart failure. All patients admitted to hospital after a detailed medical history to record blood pressure, gender and age, blood taken fasting for 12 hours the next morning, detection routine biochemical indicators, using the enzyme-linked immunosorbent assay in patients with plasma GDF-15 level, within 48 hours of admission are electrocardiogram, chest X-ray, echocardiography. The diagnosis of heart failure according to the Framingham criteria. Heart failure patients with NYHA functional class Ⅰ to Ⅳ. The divided heart failure etiology of ischemic heart failure group (IHF, n = 69) and non-ischemic heart failure group (NIHF, n = 41), divided into left ventricular ejection fraction (left ventricular ejection fraction levels LVEF) ≤ 45% (n = 29) and LVEF gt; 45% group (n = 81). Normal control group (n = 36). [Results] 1 plasma GDF-15 level of the heart failure group than in the control group was significantly higher (P lt; 0.01), GDF-15 levels in IHF group with NIHF group showed no significant statistical difference (P gt; 0.05) in LVEF ≤ 45% with LVEF gt; between the 45% group and no statistically significant difference (P gt; 0.05). Plasma GDF-15 levels increased with the severity of the New York class (NYHA), cardiac function, plasma GDF-15 level in New York grade Ⅰ control group, Ⅰ and Ⅱ stage was no statistically significant difference. 3.GDF-15 level with NYHA class (r = 0.567, P = 0.00), LVEDD (r = 0.209, P = 0.030) showed a significant positive correlation; and left ventricular ejection fraction (r = -0.226, P = 0.019) was significantly negatively correlated. Further multivariate linear regression analysis including age, sex, functional class, BNP, LAD, LVEDD, LVEF, LVPW, IVS results only NYHA class (B = 0.576, P = 0.000) and GDF-15 closely related. 4 The application of the receiver operating characteristic curve (ROC) curve analysis: GDF-15 can be used for diagnosis of chronic heart failure with BNP. GDF-15 compared with BNP, its value in the diagnosis of heart failure subgroups was not statistically different. Joint GDF-15, and the BNP two kinds of indicators alone BNP compared with its value in the diagnosis of heart failure subgroups was not statistically different. [Conclusion] heart failure patients with plasma GDF-15 level was significantly higher than the control group; but also to reflect the severity of heart failure, heart failure markers can be used for the assessment of the clinical condition of patients with heart failure. 2. GDF-15 levels in chronic myocardial ischemia due to heart failure and non-ischemic etiology was no significant difference due to heart failure; LVEF ≤ 45% group and LVEF gt; comparison of 45% between the two groups and no significant statistically significant. 3 compared with BNP, GDF-15 value of each sub-group in the diagnosis of heart failure was no significant difference. Joint GDF-15, and the BNP two kinds of indicators alone BNP compared with its value in the diagnosis of heart failure subgroups was not statistically different.

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Blood circulation failure
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