CAN GDF-15 BE USED AS A BIOMARKER IN DILATED CARDIOMYOPATHY
Nandini Nair, M.D., Ph.D., Texas Tech HSC, Lubbock, TX, USA
Growth and Differentiation Factor-15 (GDF-15) has been found to play an important role in fibrosis, inflammation and ventricular remodeling. The role of GDF-15 in regulation of cardiac remodeling in idiopathic dilated cardiomyopathy (DCM) is less well-defined. A review of existing literature on the utility of GDF-15 in diagnosis and prognosis is presented here.GDF-15 is up regulated along with brain natriuretic peptide (BNP) in the setting of increasing wall stress. GDF-15 also correlates well with other biomarkers such as soluble ST2 in this sub population. A moderate association is also noted with functional capacity as well as echocardiographic indices (left ventricular ejection fraction and Left ventricular internal dimension). Other interesting associations of GDF-15 included varying degrees of association with different serum matrix metalloproteinases (TIMP, MMP2, MMP3, and MMP9).GDF-15 is elevated in many disease conditions including sepsis. Hence it is unlikely to be useful as a solo biomarker in specific diagnosis. GDF-15 could prove useful when used along with BNP or as part of a panel of biomarkers.