Clinical Significance Of Serum GDF-15 And P?NP In Heart Failure

Objective: Heart failure is the clinical performance of end-stage of various heart diseases with high incidence and mortality.Therefore,early diagnosis and standardized treatment are expected to improve the survival rate of patients with heart failure.Growth differentiation factor 15(GDF-15)is a new biomarker of inflammatory response to cardiac injury.N-terminal peptide of Type ? procollagen(P?NP)is an indirect indicator of extracellular matrix collagen metabolism.The main pathological change of heart failure is pathological ventricular remodeling after heart damage.The purpose of this experiment is to study the relationship between serum GDF-15 and P?NP,and to study the relevance between the two and the level of N-terminal pro-B-type natriuretic peptide(NT-pro BNP)in patients with heart failure,and to detect the correlation between the two and the indexes related to heart function,and to explore the clinical significance of serum GDF-15 and P?NP in the diagnosis and assessment of heart failure.Materials and Methods: From September 2018 to June 2019,134 patients were selected from the Second Affiliated Hospital of Dalian Medical University in the heart failure ward,including 91 patients with heart failure in the experimental group and 43 patients without heart failure in the control group.In the next morning after admission,all the selected patients' elbow venous blood was collected on an empty stomach.The concentration of serum GDF-15 was measured by enzyme-linked immunosorbent assay(ELISA).NT-pro BNP and P?NP were measured by electro-chemiluminescence immunoassay.Left Ventricular End-diastolic Diameter(LVEDD)and Left Ventricular Ejection Fraction(LVEF)were measured by the Cardiac Color Doppler Ultrasonography.The data were analyzed by spss22.0 statistical software package.The levels of serum GDF-15 and P?NP were compared between the two groups.The relationship between them and NT-pro BNP,LVEDD,LVEF in heart failure patients was observed.The ROC curve was used to analyze the value of serum GDF-15 and P?NP in the diagnosis of heart failure.Results: 1.Compared with the control group,the level of serum GDF-15 in heart failure group increased significantly(38.82±13.80pg/ml vs 149.32±182.85pg/ml,p<0.001).The level of serum GDF-15 in heart failure group increased with the increase of NT-pro BNP and LVEDD values(r=0.594,p<0.001;r=0.317,p=0.002 respectively),showing a positive correlation;but increased with the decline of LVEF value(r=-0.399,p<0.001),showing a negative correlation.2.Compared with the control group,the level of serum P?NP in heart failure group increased significantly(21.58±8.83ng/ml vs 51.70±33.41ng/ml,p<0.001).The level of serum P?NP in heart failure group increased with the increase of NT-pro BNP and LVEDD values(r=0.316,p=0.002;r=0.273,p=0.009 respectively),showing a positive correlation;but increased with the decline of LVEF value(r=-0.343,p=0.001),showing a negative correlation.3.The level of serum GDF-15 in heart failure group increased with the increase of serum P?NP(r=0.403,p<0.001),showing a positive correlation.4.The area under ROC curve of serum GDF-15 was 0.843(95%CI:0.777-0.908,p<0.001).The optimum cut-off value of serum GDF-15 in the diagnosis of heart failure was 58.349pg/ml.In addition,the area under ROC curve of serum P?NP was 0.883(95%CI:0.823-0.944,p<0.001).The optimum cut-off value of serum P?NP in the diagnosis of heart failure was 28.08ng/ml.It suggested that serum GDF-15 and P?NP might have diagnostic value for heart failure.Conclusion:1.The level of serum GDF-15 in heart failure group increased with the aggravation of heart failure,indicating that serum GDF-15 might reflect the severity of heart failure.2.The level of serum P?NP in heart failure group increased with the aggravation of heart failure,indicating that serum P?NP might reflect the degree of myocardial fibrosis and the severity of heart failure.3.The level of serum GDF-15 in patients with heart failure increased with the increase of serum P?NP,indicating that there might be a positive correlation between the two in the development of heart failure.4.Serum GDF-15 and P?NP might be helpful in the diagnosis of heart failure.