Role and prognostic value of growth differentiation factor 15 in patient of heart failure with preserved ejection fraction: insights from the PURSUIT-HFpEF registry.

IF 2.8 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Open Heart Pub Date : 2025-01-19 DOI:10.1136/openhrt-2024-003008

Daisuke Sakamoto, Yuki Matsuoka, Daisaku Nakatani, Katsuki Okada, Akihiro Sunaga, Hirota Kida, Taiki Sato, Tetsuhisa Kitamura, Shunsuke Tamaki, Masahiro Seo, Masamichi Yano, Takaharu Hayashi, Akito Nakagawa, Yusuke Nakagawa, Yoshio Yasumura, Takahisa Yamada, Shungo Hikoso, Yohei Sotomi, Yasushi Sakata

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Abstract

Background: Growth differentiation factor 15 (GDF15) is a cytokine responding to oxidative stress and inflammation, and it regulates appetite and energy balance. The association between GDF15 and clinical factors and its prognostic value in elderly multimorbid patients with heart failure with preserved ejection fraction (HFpEF) have not been well unknown.

Methods: This exploratory analysis is part of the Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with preserved Ejection Fraction study (N=1231), an ongoing, prospective, multicentre observational study of acute decompensated HFpEF (UMIN000021831). A predefined subcohort of 212 patients underwent multi-biomarker testing. Of these, we analysed 181 patients with available GDF15 data. The primary endpoint was a composite of all-cause death and hospitalisation for HF.

Results: In this analysis population, the median age was 81 (75-85) years, with 48% male patients. GDF15 significantly correlated with cardiac burden, anaemia, renal dysfunction and inflammation. Notably, poor nutritional status was significantly associated with GDF15. GDF15 was linked to poor prognosis in this elderly multimorbid cohort with HFpEF (adjusted HR for log-transformed GDF15: 13.67, 95% CI: 2.78 to 67.22, p=0.001). Furthermore, GDF15 added significant incremental value to the MAGGIC risk score (net reclassification improvement=0.4955 (95% CI: 0.1367 to 0.8543), p=0.007; integrated discrimination improvement=0.0278 (95% CI: 0.0013 to 0.0543), p=0.040).

Conclusions: GDF15 was associated with anaemia, inflammation, renal dysfunction, cardiac burden and malnutrition. It demonstrated prognostic value in elderly multimorbid HFpEF patients, suggesting its potential role as a complementary marker for the prognostic risk assessment of HFpEF patients.

Trial registration number: UMIN-CTR ID: UMIN000021831.

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生长分化因子15在保留射血分数的心力衰竭患者中的作用和预后价值：来自PURSUIT-HFpEF登记的见解

背景：生长分化因子15 （Growth differentiation factor 15, GDF15）是一种响应氧化应激和炎症的细胞因子，调节食欲和能量平衡。GDF15与临床因素之间的关系及其在老年多病心力衰竭保留射血分数（HFpEF）患者中的预后价值尚不清楚。方法：该探索性分析是保留射血分数的心力衰竭患者前瞻性多中心观察性研究（N=1231）的一部分，这是一项正在进行的急性失代偿性HFpEF的前瞻性多中心观察性研究（UMIN000021831）。预先确定的212名患者亚队列接受了多种生物标志物检测。其中，我们分析了181例具有可用GDF15数据的患者。主要终点是HF的全因死亡和住院。结果：在本分析人群中，中位年龄为81（75-85）岁，男性患者占48%。GDF15与心脏负荷、贫血、肾功能不全、炎症有显著相关性。值得注意的是，营养状况不良与GDF15显著相关。GDF15与患有HFpEF的老年多病队列预后不良相关（对数转换GDF15的校正HR: 13.67, 95% CI: 2.78 ~ 67.22, p=0.001）。此外，GDF15显著增加了MAGGIC风险评分的增量值(净重分类改善=0.4955 (95% CI: 0.1367至0.8543),p=0.007；综合鉴别改善=0.0278 (95% CI: 0.0013 ~ 0.0543), p=0.040)。结论：GDF15与贫血、炎症、肾功能障碍、心脏负担和营养不良有关。它在老年多病HFpEF患者中显示了预后价值，提示其可能作为HFpEF患者预后风险评估的补充标志物。试验注册号：UMIN-CTR ID: UMIN000021831。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Open Heart CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.60

自引率

3.70%

发文量

145

审稿时长

20 weeks

期刊介绍： Open Heart is an online-only, open access cardiology journal that aims to be “open” in many ways: open access (free access for all readers), open peer review (unblinded peer review) and open data (data sharing is encouraged). The goal is to ensure maximum transparency and maximum impact on research progress and patient care. The journal is dedicated to publishing high quality, peer reviewed medical research in all disciplines and therapeutic areas of cardiovascular medicine. Research is published across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Opinionated discussions on controversial topics are welcomed. Open Heart aims to operate a fast submission and review process with continuous publication online, to ensure timely, up-to-date research is available worldwide. The journal adheres to a rigorous and transparent peer review process, and all articles go through a statistical assessment to ensure robustness of the analyses. Open Heart is an official journal of the British Cardiovascular Society.