title: [GDF-15, MRproADM, CTproET1, and CTproAVP in patients with asymptomatic diastolic dysfunction].
abstract: BACKGROUND
  The role of biomarkers in asymptomatic diastolic dysfunction (DD) has not been investigated so far. The aim of the study was to evaluate the clinical associations and the diagnostic property of different biomarkers in patients with asymptomatic DD.
  
  
  METHODS
  Within a population based observational study, healthy participants (50-85 years) with an LVEF ≥ 50 % and no cardiovascular risk factor were prospectively identified. Patients were classified as having either DD (grade ≥ 1, n = 103) or no DD (CON: n = 85). All patients underwent physical examination including medical history, six-minute-walk-testing, QoL (SF-36), comprehensive echocardiography and blood sampling to measure routine values and specified biomarkers (NTproBNP, MRproANP, GDF-15, MRproADM, CTproET1, CTproAVP).
  
  
  RESULTS
  In the DD-group plasma concentration of GDF-15 (p = 0,002), MRproADM (p < 0,001), and CTproAVP (p = 0,003) were significantly higher than in the CON-group. In contrast, NTproBNP (p = 0,390), MRproANP (p = 287), and CTproET1 (p = 0,393) did not differ. GDF-15, MRproADM and CTproAVP were significantly associated with the presence of DD. However, the significance of the seen associations was lost after multiple adjustments. NTproBNP, MRproANP, and MRproADM were significantly related to E / e' as a continuous measure of diastolic function. The significance of the seen associations was lost after multiple adjustments. In ROC analyses, none of the investigated biomarkers was able to relevantly improve the diagnosis of DD.
  
  
  CONCLUSIONS
  In patients with asymptomatic DD plasma concentrations of GDF-15, MRproADM and CT-proAVP were significantly higher when compared with controls. In contrast, NTproBNP, MRproANP and CTproET1 did not differ. After adjustment for age, sex, BMI and renal function, no significant association between DD or E / e' and different biomarkers could be observed. Furthermore, none of the investigated biomarkers was able to substantially improve the diagnosis of DD.
authors.affiliation: Klinik für Kardiologie und Pneumologie, Universitätsmedizin Göttingen.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Nolte
authors.affiliation: Klinik für Kardiologie und Pneumologie, Universitätsmedizin Göttingen.
authors.forename: Fabian
authors.initials: F
authors.lastname: Gabriel
authors.affiliation: Abteilung Innere Medizin, HELIOS Albert-Schweizer-Klinik Northeim.
authors.forename: Raoul
authors.initials: R
authors.lastname: Stahrenberg
authors.affiliation: Klinik für Kardiologie und Pneumologie, Universitätsmedizin Göttingen.
authors.forename: Mark
authors.initials: M
authors.lastname: Weber-Krüger
authors.affiliation: Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Göttingen.
authors.forename: Christoph
authors.initials: C
authors.lastname: Herrmann-Lingen
authors.affiliation: Klinik für Kardiologie und Pneumologie, Universitätsmedizin Göttingen.
authors.forename: Gerd
authors.initials: G
authors.lastname: Hasenfuß
authors.affiliation: Klinik für Kardiologie und Pneumologie, Universitätsmedizin Göttingen.
authors.forename: Rolf
authors.initials: R
authors.lastname: Wachter
authors.affiliation: Klinik für Kardiologie und Pneumologie, Universitätsmedizin Göttingen.
authors.forename: Frank
authors.initials: F
authors.lastname: Edelmann
mesh_terms: D053607:Adrenomedullin / Q000097:blood*; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D002303:Cardiac Output, Low / Q000097:blood / Q000175:diagnosis; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D006020:Glycopeptides / Q000097:blood*; D055436:Growth Differentiation Factor 15 / Q000097:blood*; D054144:Heart Failure, Diastolic / Q000097:blood* / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011498:Protein Precursors / Q000097:blood*; D012016:Reference Values; D012307:Risk Factors
chemical_list: D015415:Biomarkers; C557077:C-terminal proendothelin-1; D019332:Endothelin-1; C526140:GDF15 protein, human; D006020:Glycopeptides; D055436:Growth Differentiation Factor 15; D010446:Peptide Fragments; D011498:Protein Precursors; C048197:copeptins; C574167:mid-regional pro-adrenomedullin, human; D053607:Adrenomedullin