Open Heart (Jan 2025)

Role and prognostic value of growth differentiation factor 15 in patient of heart failure with preserved ejection fraction: insights from the PURSUIT-HFpEF registry

  • ,
  • Tetsuhisa Kitamura,
  • Shungo Hikoso,
  • Takahisa Yamada,
  • Yoshio Yasumura,
  • Akito Nakagawa,
  • Toshihiro Takeda,
  • Hirota Kida,
  • Akihiro Sunaga,
  • Tomoharu Dohi,
  • Katsuki Okada,
  • Daisaku Nakatani,
  • Yasushi Matsumura,
  • Yasushi Sakata,
  • Shunsuke Tamaki,
  • Takaharu Hayashi,
  • Yoshiharu Higuchi,
  • Masaharu Masuda,
  • Mitsutoshi Asai,
  • Toshiaki Mano,
  • Hisakazu Fuji,
  • Daisaku Masuda,
  • Shizuya Yamashita,
  • Masami Sairyo,
  • Yusuke Nakagawa,
  • Haruhiko Abe,
  • Yasunori Ueda,
  • Kunihiko Nagai,
  • Masamichi Yano,
  • Masami Nishino,
  • Jun Tanouchi,
  • Yoh Arita,
  • Shinji Hasegawa,
  • Takamaru Ishizu,
  • Minoru Ichikawa,
  • Yuzuru Takano,
  • Eisai Rin,
  • Tetsuya Watanabe,
  • Shiro Hoshida,
  • Masahiro Izumi,
  • Hiroyoshi Yamamoto,
  • Hiroyasu Kato,
  • Kazuhiro Nakatani,
  • Mayu Nishio,
  • Keiji Hirooka,
  • Takahiro Yoshimura,
  • Akihiro Tani,
  • Yasushi Okumoto,
  • Yasunaka Makino,
  • Katsuomi Iwakura,
  • Yoshiyuki Kijima,
  • Takashi Kitao,
  • Masashi Fujita,
  • Koichiro Harada,
  • Masahiro Kumada,
  • Osamu Nakagawa,
  • Ryo Araki,
  • Takayuki Yamada,
  • Fusako Sera,
  • Kei Nakamoto,
  • Hidetaka Kioka,
  • Tomohito Ohtani,
  • Nobuyuki Ogasawara,
  • Yukinori Shinoda,
  • Koichi Tachibana,
  • Yohei Sotomi,
  • Taiki Sato,
  • Yuji Yasuga,
  • Toshinari Onishi,
  • Kazunori Kashiwase,
  • Ryu Shutta,
  • Masahiro Seo,
  • Yuki Matsuoka,
  • Yasuhiro Akazawa,
  • Daisuke Sakamoto

DOI
https://doi.org/10.1136/openhrt-2024-003008
Journal volume & issue
Vol. 12, no. 1

Abstract

Read online

Background Growth differentiation factor 15 (GDF15) is a cytokine responding to oxidative stress and inflammation, and it regulates appetite and energy balance. The association between GDF15 and clinical factors and its prognostic value in elderly multimorbid patients with heart failure with preserved ejection fraction (HFpEF) have not been well unknown.Methods This exploratory analysis is part of the Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with preserved Ejection Fraction study (N=1231), an ongoing, prospective, multicentre observational study of acute decompensated HFpEF (UMIN000021831). A predefined subcohort of 212 patients underwent multi-biomarker testing. Of these, we analysed 181 patients with available GDF15 data. The primary endpoint was a composite of all-cause death and hospitalisation for HF.Results In this analysis population, the median age was 81 (75–85) years, with 48% male patients. GDF15 significantly correlated with cardiac burden, anaemia, renal dysfunction and inflammation. Notably, poor nutritional status was significantly associated with GDF15. GDF15 was linked to poor prognosis in this elderly multimorbid cohort with HFpEF (adjusted HR for log-transformed GDF15: 13.67, 95% CI: 2.78 to 67.22, p=0.001). Furthermore, GDF15 added significant incremental value to the MAGGIC risk score (net reclassification improvement=0.4955 (95% CI: 0.1367 to 0.8543), p=0.007; integrated discrimination improvement=0.0278 (95% CI: 0.0013 to 0.0543), p=0.040).Conclusions GDF15 was associated with anaemia, inflammation, renal dysfunction, cardiac burden and malnutrition. It demonstrated prognostic value in elderly multimorbid HFpEF patients, suggesting its potential role as a complementary marker for the prognostic risk assessment of HFpEF patients.Trial registration number UMIN-CTR ID: UMIN000021831.