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Growth differentiation factor-15 in Takotsubo cardiomyopathy: diagnostic and prognostic value

T Stiermaier1, V Adams1, M Just1

  • 1University of Leipzig-Heart Center, Department of Internal Medicine-Cardiology, Leipzig, Germany.

International Journal of Cardiology
|April 1, 2014
PubMed

Insights

Growth Differentiation Factor-15 (GDF-15) levels are significantly elevated in Takotsubo cardiomyopathy (TTC) patients, predicting adverse outcomes. High GDF-15 indicates a poorer prognosis in TTC, even compared to ST-segment elevation myocardial infarction (STEMI).

Area of Science:

  • Cardiology
  • Biomarkers
  • Cardiovascular Diseases

Background:

  • Growth Differentiation Factor-15 (GDF-15) is a stress-responsive cytokine linked to adverse outcomes in cardiovascular diseases.
  • GDF-15 has not been previously evaluated in patients with Takotsubo cardiomyopathy (TTC).

Purpose of the Study:

  • To investigate the diagnostic and prognostic value of GDF-15 in patients with TTC.
  • To compare GDF-15 levels in TTC patients versus ST-segment elevation myocardial infarction (STEMI) patients.

Main Methods:

  • A cohort of 22 TTC patients was matched by age and gender with 22 STEMI patients.
  • GDF-15 concentrations were measured at admission and 1 day post-admission.
  • The primary endpoint in the TTC cohort was a composite of death, cardiogenic shock, or new congestive heart failure within 6 months.

Main Results:

  • TTC patients exhibited significantly higher GDF-15 levels on admission compared to STEMI patients (p=0.002).
  • Higher GDF-15 levels were associated with biventricular ballooning (p=0.008) and major adverse cardiac events (p=0.005) in TTC patients.
  • Elevated admission GDF-15 was the sole significant predictor of the combined clinical endpoint in multivariable analysis (p=0.02).

Conclusions:

  • Takotsubo cardiomyopathy patients present with markedly high, transient elevations in GDF-15.
  • Biventricular ballooning in TTC is associated with particularly high GDF-15 concentrations.
  • Elevated GDF-15 levels upon admission strongly predict adverse clinical outcomes in TTC.
Abstract

Keywords:
Apical ballooning syndromeGDF-15InfarctionPrognosisStress cardiomyopathyTakotsubo

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