Plasma Growth Differentiation Factor-15 as a Prognostic Biomarker in Children with Congestive Heart Failure

Aim and Objectives: This study aimed to evaluate the plasma levels of Growth Differentiation Factor-15 (GDF-15) in children with congestive heart failure, also to evaluate the diagnostic and prognostic value of this novel biomarker in pediatric congestive heart failure, by correlation of its levels with the clinical status and the echocardiographic data of these patients.

Subjects and Methods: This study was conducted on Thirty (30) children with congestive heart failure (CHF), Patients were selected from those admitted to Pediatric Cardiology Unit, Pediatric Department, Tanta University Hospital, from (August 2018-April 2020), and thirty (30) healthy children, matched for age and sex, were enrolled as a control group. All children in this study were subjected to Plain X-ray chest and heart: Cardiothoracic ratio (CTR) was measured, and Echocardiographic assessment: Doppler and Two-dimensional, M-mode Echocardiographic evaluation of these parameters and Plasma level of Growth Differentiation Factor-15 (GDF-15) was measured.

Results: the results revealed that The best cutoff point of GDF-15 to differentiate between cases with CHF and control group was >446.5 ng/l with 93.33% sensitivity, 90% specificity, 90.3% PPV, 93.1% NPV and AUC was 0.992.

There was significant decrease of EF% and FS% (systolic dysfunction of LV) in patients with CHF as compared to control group.

There was statistically significant positive correlation between plasma level of GDF-15 and Ross clinical stage of CHF.

There was statistically significant negative correlation between GDF-15 and EF%, FS % by echocardiography.

Conclusion: Plasma levels of GDF-15 were elevated in children with CHF, and these levels were correlated to the Ross staging of CHF and echocardiographic assessment of LV function. Plasma levels of GDF-15 were elevated in patients with bad prognosis, denoting its prognostic value as a novel biomarker in pediatric CHF.