title: Correlation between growth differentiation factor-15 and collagen metabolism indicators in patients with myocardial infarction and heart failure.
abstract: BACKGROUND
  Growth differentiation factor (GDF)-15, a divergent member of the transforming growth factor beta super-family does appear to be up-regulated in response to experimental pressure overload and progression of heart failure (HF). HF frequently develops after myocardial infarction (MI), contributing to worse outcome. The aim of this study is to assess the correlation between GDF-15 levels and markers related to collagen turnover in different stages of HF.
  
  
  METHODS
  The study consists of a cohort of 179 patients, including stable angina pectoris patients (AP group, n = 50), old MI patients without HF (OMI group, n = 56), old MI patients with HF (OMI-HF group, n = 38) and normal Control group (n = 35). Both indicators reflecting the synthesis and degradation rates of collagen including precollagen I N-terminal peptide (PINP), type I collagen carboxy-terminal peptide (ICTP), precollagen III N-terminal peptide (PIIINP) and GDF-15 were measured using an enzyme-linked inmunosorbent assay.
  
  
  RESULTS
  The plasma GDF-15 level was higher in OMI-HF group (1373.4 ± 275.4 ng/L) than OMI group (1036.1 ± 248.6 ng/L), AP group (784.6 ± 222.4 ng/L) and Control group (483.8 ± 186.4 ng/L) (P < 0.001). The indicators of collagen turnover (ICTP, PINP, PIIINP) all increased in the OMI-HF group compared with Control group (3.03 ± 1.02 µg/L vs. 2.08 ± 0.95 µg/L, 22.2 ± 6.6 µg/L vs. 16.7 ± 5.1 µg/L and 13.2 ± 7.9 µg/L vs. 6.4 ± 2.1 µg/L, respectively; P < 0.01). GDF-15 positively correlated with ICTP and PIIINP (r = 0.302, P < 0.001 and r = 0.206, P = 0.006, respectively). GDF-15 positively correlated to the echocardiographic diastolic indicators E/Em and left atrial pressure (r = 0.349 and r = 0.358, respectively; P < 0.01), and inversely correlated to the systolic indicators left ventricular ejection fraction and the average of peak systolic myocardial velocities (Sm) (r = -0.623 and r = -0.365, respectively; P < 0.01).
  
  
  CONCLUSIONS
  Plasma GDF-15 is associated with the indicators of type I and III collagen turnover.
authors.affiliation: Department of Cardiology & Beijing Key Laboratory of Cardiovascular Receptors Research, Peking University Health Science Center and Key Laboratory of Molecular Ministry of Education, Cardiovascular Science, Peking University Third Hospital, Hua Yuan Bei Lu, Hai Dian District, Beijing, China.
authors.forename: Fang-Fang
authors.initials: FF
authors.lastname: Wang
authors.affiliation: Department of Cardiology & Beijing Key Laboratory of Cardiovascular Receptors Research, Peking University Health Science Center and Key Laboratory of Molecular Ministry of Education, Cardiovascular Science, Peking University Third Hospital, Hua Yuan Bei Lu, Hai Dian District, Beijing, China.
authors.forename: Bao-Xia
authors.initials: BX
authors.lastname: Chen
authors.affiliation: Department of Cardiology & Beijing Key Laboratory of Cardiovascular Receptors Research, Peking University Health Science Center and Key Laboratory of Molecular Ministry of Education, Cardiovascular Science, Peking University Third Hospital, Hua Yuan Bei Lu, Hai Dian District, Beijing, China.
authors.forename: Hai-Yi
authors.initials: HY
authors.lastname: Yu
authors.affiliation: Department of Cardiology & Beijing Key Laboratory of Cardiovascular Receptors Research, Peking University Health Science Center and Key Laboratory of Molecular Ministry of Education, Cardiovascular Science, Peking University Third Hospital, Hua Yuan Bei Lu, Hai Dian District, Beijing, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Mi
authors.affiliation: Department of Cardiology & Beijing Key Laboratory of Cardiovascular Receptors Research, Peking University Health Science Center and Key Laboratory of Molecular Ministry of Education, Cardiovascular Science, Peking University Third Hospital, Hua Yuan Bei Lu, Hai Dian District, Beijing, China.
authors.forename: Zi-Jian
authors.initials: ZJ
authors.lastname: Li
authors.affiliation: Department of Cardiology & Beijing Key Laboratory of Cardiovascular Receptors Research, Peking University Health Science Center and Key Laboratory of Molecular Ministry of Education, Cardiovascular Science, Peking University Third Hospital, Hua Yuan Bei Lu, Hai Dian District, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
keywords: Biomarkers; Collagen turnover; Growth differentiation factor-15; Heart failure; Myocardial infarction