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Updated: May 30, 2026
Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
Relation of growth-differentiation factor 15 to left ventricular remodeling in ST-segment elevation myocardial
Alberto Dominguez-Rodriguez1, Pedro Abreu-Gonzalez, Pablo Avanzas
1Department of Cardiology, Hospital Universitario de Canarias, Tenerife, Spain. adrvdg@hotmail.com
Insights
Growth-differentiation factor-15 (GDF-15) is a novel predictor of left ventricular remodeling (LVR) after myocardial infarction. Early GDF-15 levels can help identify patients at high risk for heart failure, improving patient outcomes.
Area of Science:
- Cardiology
- Biomarkers
- Heart Failure Research
Background:
- Left ventricular remodeling (LVR) post-myocardial infarction (MI) significantly increases heart failure risk.
- Predicting LVR is challenging, with limited understanding of cardiac biomarker associations.
- Growth-differentiation factor-15 (GDF-15) is implicated in heart failure and cardiac remodeling processes.
Purpose of the Study:
- To investigate the association between early serum GDF-15 levels and subsequent LVR.
- To evaluate GDF-15 as a potential predictor of LVR in ST-segment elevation myocardial infarction (STEMI) patients.
Main Methods:
- Prospective study of 97 STEMI patients undergoing primary percutaneous coronary intervention.
- Echocardiography assessed LVR at baseline and 12 months (defined as >20% increase in left ventricular end-diastolic volume).
- Serum GDF-15 and brain natriuretic peptide measured within 24 hours of symptom onset.
Main Results:
- 22% of patients developed LVR.
- Higher GDF-15 levels at study entry were significantly associated with LVR (p <0.001).
- GDF-15 was identified as an independent predictor of LVR (OR 10.1, p <0.001), with an AUC of 0.77.
Conclusions:
- Serum GDF-15 levels measured within 24 hours of STEMI are a significant independent predictor of LVR.
- GDF-15 may serve as a valuable early biomarker for identifying patients at risk of adverse cardiac remodeling.
- These findings could inform risk stratification and therapeutic strategies for post-MI patients.
Abstract:
The development of left ventricular remodeling (LVR) after myocardial infarction is associated with a high risk of heart failure and death. LVR is difficult to predict, and limited information is available on the association of cardiac biomarkers and LVR. Growth-differentiation factor-15 (GDF-15) is induced during heart failure development and, in animals models, might influence the different processes involved in cardiac remodeling. The aim of the present investigation was to assess the association between the serum levels of GDF-15 within the first 24 hours of ST-segment elevation myocardial infarction and the development of subsequent LVR at 12 months of follow-up. This prospective study included 97 patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Echocardiography was performed in all patients within the first 96 hours of admission and at 12 months of follow-up. LVR was defined as a >20% increase in the left ventricular end-diastolic volume at 12 months of follow-up compared to baseline. Blood samples for the determination of GDF-15 and brain natriuretic peptide were obtained within the first 24 hours after symptom onset. According to the pre-established criteria, 21 patients (22%) had LVR. Patients with LVR had greater levels of GDF-15 at study entry (median 3,439 pg/ml, interquartile range 2,391 to 6,168 vs median 1998 pg/ml, interquartile range 1,204 to 3,067, respectively; p <0.001). Multivariate analysis showed that GDF-15 (odds ratio 10.1, 95% confidence interval 2.5 to 40.1, p <0.001) and treatment with angiotensin-converting enzyme inhibitors (odds ratio 3.9, 95% confidence interval 1.2 to 12.3, p <0.01) were independents predictors of LVR. Receiving operating characteristics analysis showed an area under the curve of 0.77 for GDF-15 (95% confidence interval 0.67 to 0.84, p <0.001). In conclusion, the results of the present study have identified GDF-15 as an independent marker of LVR in patients with ST-segment elevation myocardial infarction.
