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

作者：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 · 发表于：Open Heart · 年份：2025 · DOI：10.1136/openhrt-2024-003008 · 被引用次数：10 · 研究领域：GDF15 and Related Biomarkers、IL-33, ST2, and ILC Pathways、Cardiac Fibrosis and Remodeling

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....