Background: Growth-differentiation factor-15 (GDF-15), a cytokine with broad cardiac and non-cardiac activity, has diagnostic and prognostic value in various diseases, including heart failure. We aimed to investigate the release of GDF-15 in adults with congenital heart disease (ConHD), and assess the association with cardiac function and functional capacity.
Methods: A total of 587 consecutive adults with ConHD underwent electrocardiography, echocardiography, venepuncture and were seen by a cardiologist. A subset of 143 patients underwent bicycle ergometry on the same day.
Results: Median plasma GDF-15 was 618 ng/L. In 87 patients, GDF-15 was above the reference value of normal. GDF-15 levels were higher in older patients. GDF-15 was higher in patients with elevated pulmonary pressure. In multivariate analysis adjusting for age, sex, and NT-proBNP, hs-TnT and hs-CRP, GDF-15 above the reference value was associated with NYHA class, and decreased exercise capacity, but not with systolic ventricular function or ECG rhythm.
Conclusions: GDF-15 is elevated in a substantial number of patients and higher in those with elevated pulmonary pressures, regardless of underlying congenital diagnosis. GDF-15 is associated with NYHA class, NT-proBNP and exercise capacity, suggesting the marker has diagnostic and potential prognostic value in adults with ConHD.

Additional Metadata
Keywords Adult congenital heart disease, Echocardiography, Growth differentiation factor 15, Ventricular function
Persistent URL dx.doi.org/10.1016/j.ijcard.2015.09.010, hdl.handle.net/1765/87168
Journal International Journal of Cardiology
Citation
Eindhoven, J.A, van den Bosch, A.E, Oemrawsingh, R.M, Baggen, V.J.M, Kardys, I, Cuypers, J.A.A.E, … Boersma, H. (2016). Release of growth-differentiation factor 15 and associations with cardiac function in adult patients with congenital heart disease. International Journal of Cardiology, 202, 246–251. doi:10.1016/j.ijcard.2015.09.010