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Some of the studies had a low sample size and thus the results have to be interpreted with caution. Further studies are warranted in these areas, to determine the ability of HF to diagnose Stage B HF and, to document the influence of ischemic etiology on the prognostic ability of GDF Almost all studies were done in Caucasian populations and their results may not be generalizable. As a consequence, GDF is not considered to be a cardiac specific marker. A multi-biomarker strategy with GDF as one of the components may be superior to the conventional risk scores especially for systemic conditions such as HF. Growth-differentiation factor and major cardiac events. If GDF is indeed anti hypertrophic and anti-remodeling in function, increased levels of the biomarker must, intuitively, indicate improved ventricular performance and normal LV geometry.

Only 12 studies reported the follow-up duration; the mean of which was 3. Several diagnostic and prognostic biomarkers are being explored in heart failure. More studies are warranted to elucidate the molecular pathways involving GDF and to see how knowledge about GDF can be used to make therapeutic decisions in the clinic. MIC-1 serum level and genotype: In-vivo studies suggest that GDF is cardioprotective, and that its expression reflects the onset of cardiac damage and its participation in the mitigation of damage [ 7 , 10 ]. Therefore, studies performed in cardiovascular disease populations and in the community have explored the additional prognostic value offered by GDF, incremental to conventional markers of CV risk, clinical signs and symptoms, NTproBNP, hsCRP, troponins, and a gamut of other novel biomarkers. GDF remained an independent predictor of mortality adjusted hazard ratio for1Unit in the Ln scale 2. Furthermore, Lok et al.

As a consequence, GDF is not considered to be a cardiac specific marker.

Infusion of recombinant GDF in GDF gene targeted mice under the stress of ischemia or reperfusion injury prevent cardiomyocyte cell death [ 10 ].

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The Rancho-Bernado study, a community qmrit study observed that high GDF levels were predictive of cardiovascular mortality, a decade after measurement in populations with no CV-risk.

While the exact function of GDF is still not completely understood, it has been shown to be weakly expressed in all tissue types under normal physiological states [ 7 ]. Similar findings were observed in the Womens Health study, where elevated GDF levels contributed a two-fold greater risk in the development of CV events [ 16 – 18 ]. Only 12 vzrsha reported the follow-up duration; the mean of which was 3.

GDF 15 – A Novel Biomarker in the Offing for Heart Failure

Growth differentiation factor 15 in different stages of heart failure: There is reasonable evidence to suggest that GDF is an independent predictor of all-cause mortality in HF. Almost all studies were done in Caucasian populations and their results may not be generalizable.

Studies which link GDF and mortality. The studies comprised a total of 20, participants, and had cardiovascular events and cardiovascular deaths. HF being a systemic condition, a multi-marker panel including markers reflecting cardiac and systemic abnormalities might prove useful in prognosticating this patient population, providing information that is incremental to cardiac specific markers [ 16 ].

Published online Feb. Since stage Xmrit HF is asymptomatic, diagnoses is made only after the patient progresses to more advanced stages of HF. Concentration in plasma of macrophage inhibitory cytokine-1 and risk of cardiovascular events in women: Growth differentiation factor 15 in cardiovascular diseases: Plasma natriuretic peptide levels and the risk of cardiovascular events and death. On a biological scale, the exact role of GDF in the pathophysiology of HF remains to be elucidated.

MIC-1 serum level and genotype: National heart failure audit. The authors deliberate whether elevated levels indicate the involvement of GDF in the long pathobiological processes that eventually result in cardiovascular events [ 13 ].

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All-cause mortality, cardiac biomarker, GDFheart failure, novel biomarker, prognosis. As there is a dearth of data on GDF and LV remodeling, it is imperative that more prospective studies are carried out to establish the suitability of GDF as an independent predictor of LV remodeling.

More studies are warranted to elucidate the molecular pathways involving GDF and to see how knowledge about GDF can be used to make therapeutic decisions in the clinic. Aruna Sridhar for her valuable inputs during the editing of the manuscript. Therefore, studies performed in cardiovascular disease populations and in the community have explored the additional prognostic value offered by GDF, incremental to conventional markers of CV risk, clinical signs and symptoms, NTproBNP, hsCRP, troponins, and a gamut of other novel biomarkers.

Journal List Curr Cardiol Rev v. Our systematic review is not without limitations. Growth differentiation factor is a useful prognostic marker in patients with heart failure with preserved ejection fraction.

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Large-scale delineation of secreted protein biomarkers overexpressed in cancer tissue and serum. The novel biomarker growth differentiation factor 15 in heart failure with normal ejection fraction. Exploratory factor analysis of a panel of 37 biomarkers to predict adverse events in the post MI population was conducted.

For example, studies by Lok et al. A total of nine studies reported the association between GDF and all-cause mortality. Baseline characteristics of patients in selected studies.