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Growth Differentiation Factor 15 is Related with Left Ventricular Recovery in Patients with ST-Elevation Myocardial
Mustafa Umut Somuncu1, Fatih Pasa Tatar1, Belma Kalayci1
1Department of Cardiology, Zonguldak Bulent Ecevit University Faculty of Medicine, Zounguldak.
Insights
Lower levels of growth differentiation factor 15 (GDF-15) predict better left ventricular (LV) recovery and less adverse remodeling in ST-elevation myocardial infarction (STEMI) patients. This finding aids in understanding LV function post-revascularization.
Area of Science:
- Cardiology
- Biomarkers
- Cardiac Imaging
Background:
- Determinants of left ventricular (LV) recovery post-revascularization in ST-elevation myocardial infarction (STEMI) are not fully understood.
- The association between growth differentiation factor 15 (GDF-15) and left ventricular ejection fraction (LVEF) improvement remains unclear.
- This study investigates the hypothesis that lower GDF-15 levels correlate with improved LVEF recovery.
Purpose of the Study:
- To identify predictors of left ventricular (LV) recovery in ST-elevation myocardial infarction (STEMI) patients.
- To explore the relationship between baseline growth differentiation factor 15 (GDF-15) levels and LV functional improvement.
- To assess the impact of GDF-15 on adverse cardiac remodeling after myocardial infarction.
Main Methods:
- 161 STEMI patients underwent echocardiography before and 12-18 weeks post-discharge.
- Patients were stratified into groups based on LVEF change (≥10%, 1-9%, ≤0%).
- LV recovery was defined as ≥10% LVEF improvement; predictors were analyzed, and groups were compared based on GDF-15 levels.
Main Results:
- LV recovery occurred in 38.5% of patients.
- Independent predictors of LV recovery included lower baseline LVEF, lower GDF-15, previous angina, and shorter symptom-to-balloon time.
- Patients with lower GDF-15 exhibited significantly reduced LV end-diastolic volume index, LV end-systolic volume index, and wall motion score index, indicating less adverse remodeling.
Conclusions:
- Lower GDF-15 levels are significantly associated with better LV functional recovery after STEMI.
- Reduced GDF-15 predicts less adverse cardiac remodeling in STEMI patients.
- GDF-15 may serve as a valuable biomarker for predicting LV recovery and remodeling post-myocardial infarction.
Background:
The determinants of left ventricular (LV) recovery after successful revascularization in ST-elevation myocardial infarction (STEMI) patients are not clear. In addition, the relationship between growth differentiation factor15 (GDF-15) and left ventricular ejection fraction (LVEF) improvement is also unknown. This study hypothesizes that a low GDF-15 level would be associated with LVEF recovery.
Methods:
One hundred and sixty-one STEMI patients were included in this study. Echocardiographic examinations were performed before and 12-18 weeks after discharge. The patients were divided into three groups according to the changes in LVEF as 62 patients with ≥ 10% change, 47 patients with 1-9% change, and 52 patients ≤ 0% change. LV recovery was defined as ≥ 10% LVEF improvement and the predictors of LV recovery were investigated. Moreover, two groups were created according to GDF-15 values, and the follow-up/baseline echocardiographic parameters were compared between these groups.
Results:
LV recovery was detected in 38.5% of the patients. Low baseline LVEF [odds ratio (OR): 0.85, 95% confidence interval (CI) 0.82-0.94, p = 0.001], low GDF-15 (OR: 0.79, 95% CI 0.68-0.93, p = 0.004), previous angina (OR: 2.34, 95% CI 1.10-4.96, p = 0.027), and symptom-to-balloon time (OR: 0.97, 95% CI 0.95-1.00, p = 0.043) were independent predictors of LV recovery. The ratios of follow-up/baseline LV end-diastolic volume index, LV end-systolic volume index and wall motion score index were lower in the low GDF-15 group (0.96 vs. 1.04, p < 0.001; 0.96 vs. 1.10, p < 0.001; 0.89 vs. 0.96, p < 0.001). Moreover, being in the low GDF-15 group was associated with LV recovery (OR: 2.93, 95% CI 1.43-6.02, p = 0.001).
Conclusions:
Lower GDF-15 level was associated with better LV improvement and less adverse remodeling in STEMI patients.
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