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Updated: Jun 17, 2026

In Vitro Model of Coronary Angiogenesis
Published on: March 10, 2020
Growth differentiation factor 15 and coronary collateral formation
Tao Sun1, Yanbo Huang, M Ian Phillips
1Department of Cardiology, Huashan Hospital, Fudan University, Shanghai, China.
Insights
Growth differentiation factor 15 (GDF-15) levels increase with coronary collateral development. Higher GDF-15 may indicate more severe coronary stenosis and a greater likelihood of collateral formation in patients with coronary heart disease.
Area of Science:
- Cardiology
- Biochemistry
- Medical Research
Background:
- Coronary collateral circulation mitigates adverse cardiac events like myocardial infarction.
- Growth differentiation factor 15 (GDF-15), a TGF-beta superfamily member, shows prognostic value in coronary artery disease.
- The relationship between GDF-15 and coronary collateralization requires further investigation.
Purpose of the Study:
- To investigate the association between Growth differentiation factor 15 (GDF-15) and coronary collateral development.
- To determine if GDF-15 levels correlate with the extent of collateral formation in patients with coronary heart disease.
Main Methods:
- A cross-sectional study involving 201 patients undergoing coronary angiography.
- Patients categorized into three groups based on Rentrop's collateral classification (grades 1-3, grade 0, and normal coronary angiogram).
- Plasma levels of GDF-15, ADMA, and sFLT-1 were measured and compared across groups.
Main Results:
- Significant differences in plasma GDF-15, ADMA, and sFLT-1 levels were observed among collateral groups.
- A positive correlation was found between Rentrop's grade and GDF-15 levels (r = 0.187, P < 0.05).
- Significant correlations were also noted between Rentrop's grade and sFLT-1 (r = 0.181, P < 0.05) and ADMA (r = -0.646, P < 0.001).
Conclusions:
- GDF-15 levels are positively associated with the extent of coronary collateral formation.
- Elevated GDF-15 may predict more severe coronary stenosis and a higher propensity for collateral development.
- GDF-15 serves as a potential biomarker for assessing coronary collateralization in patients with coronary heart disease.
Background:
The coronary collateral circulation can reduce sudden cardiac death,myocardial cell loss,and infarct size.Growth differentiation factor 15(GDF-15),a member of the transforming growth factor-beta (TGF-beta) superfamily,has been reported to have a prognostic predicting value in coronary artery disease.
Hypothesis:
GDF-15 can be related with the extent of collateral formation.
Objective:
Growth differentiation factor 15 (GDF-15), a member of the transforming growth factor-beta (TGF-beta) superfamily, has been reported to have a prognostic predicting value in coronary artery disease. We sought to investigate whether GDF-15 is related to coronary collateral development in patients with coronary heart disease.
Methods:
A cross-sectional study was performed in 201 patients, who were admitted for selective coronary angiography. Patients were divided into 3 groups based on Rentrop's classification of coronary collaterals. Group 1: patients with coronary collateral presence, which was defined by Rentrop's grade 1-3 collateral development. Group 2: patients with grade 0 collateral development. Group 3: control group were patients with a normal coronary angiogram. The levels of plasma GDF-15, asymmetric dimethylarginine (ADMA), and soluble Fms-related tyrosine kinase-1 (sFLT-1) were compared among the 3 groups.
Results:
There were significant statistical differences in plasma sFLT-1, ADMA, and GDF-15 concentrations among the different collateral groups. The correlations between Rentrop's grade and the cytokines were significant. A positive correlation was found between Rentrop's grade and GDF-15 (r = 0.187, P < 0.05). The correlations between the levels of plasma sFLT-1, ADMA, and Rentrop's grade were significant, with the correlation coefficient of r = 0.181, P < 0.05 (sFLT-1) and r = - 0.646, P < 0.001 (ADMA), respectively.
Conclusions:
Our findings suggest that GDF-15 levels increase with the extent of collateral formation. In that case, the patients with a higher level of GDF-15 may predict more severe coronary stenosis, which has a higher probability to develop collaterals.
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