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

• Published in: Open heart 2025-01, Vol.12 (1), p.e003008
• Main Authors: Sakamoto, Daisuke, Matsuoka, Yuki, Nakatani, Daisaku, Okada, Katsuki, Sunaga, Akihiro, Kida, Hirota, Sato, Taiki, Kitamura, Tetsuhisa, Tamaki, Shunsuke, Seo, Masahiro, Yano, Masamichi, Hayashi, Takaharu, Nakagawa, Akito, Nakagawa, Yusuke, Yasumura, Yoshio, Yamada, Takahisa, Hikoso, Shungo, Sotomi, Yohei, Sakata, Yasushi, Dohi, Tomoharu, Watanabe, Tetsuya, Higuchi, Yoshiharu, Masuda, Masaharu, Asai, Mitsutoshi, Mano, Toshiaki, Fuji, Hisakazu, Masuda, Daisaku, Shutta, Ryu, Yamashita, Shizuya, Sairyo, Masami, Abe, Haruhiko, Ueda, Yasunori, Matsumura, Yasushi, Nagai, Kunihiko, Nishino, Masami, Tanouchi, Jun, Arita, Yoh, Ogasawara, Nobuyuki, Ishizu, Takamaru, Ichikawa, Minoru, Takano, Yuzuru, Rin, Eisai, Shinoda, Yukinori, Tachibana, Koichi, Hoshida, Shiro, Izumi, Masahiro, Yamamoto, Hiroyoshi, Kato, Hiroyasu, Nakatani, Kazuhiro, Yasuga, Yuji, Nishio, Mayu, Hirooka, Keiji, Yoshimura, Takahiro, Kashiwase, Kazunori, Hasegawa, Shinji, Tani, Akihiro, Okumoto, Yasushi, Makino, Yasunaka, Onishi, Toshinari, Iwakura, Katsuomi, Kijima, Yoshiyuki, Kitao, Takashi, Fujita, Masashi, Harada, Koichiro, Kumada, Masahiro, Nakagawa, Osamu, Araki, Ryo, Yamada, Takayuki, Akazawa, Yasuhiro, Nakamoto, Kei, Sera, Fusako, Kioka, Hidetaka, Ohtani, Tomohito, Takeda, Toshihiro
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Anemia; Biomarkers; Biomarkers - blood; Body mass index; Cardiac arrhythmia; Cardiovascular disease; Diabetes; Ejection fraction; Epidemiology; Female; Frailty; Growth Differentiation Factor 15 - blood; HEART FAILURE; Heart Failure - blood; Heart Failure - diagnosis; Heart Failure - mortality; Heart Failure - physiopathology; Heart failure and cardiomyopathies; Hemoglobin; Humans; Inflammation; Male; Malnutrition; Missing data; Nutritional status; Observational studies; Patients; Peptides; Prognosis; Prospective Studies; Registries; Regression analysis; Risk assessment; Risk Assessment - methods; Risk Factors; Stroke Volume - physiology; Variables; Ventricular Function, Left - physiology
• ISSN: 2053-3624; 2398-595X; 2053-3624
• DOI: 10.1136/openhrt-2024-003008

BackgroundGrowth 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.MethodsThis 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.ResultsIn 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).ConclusionsGDF15 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 numberUMIN-CTR ID: UMIN000021831.