Abstract
Growth differentiation factor-15 (GDF-15) has been identified as an endogenous anti-hypertrophy effect. However, the association of plasma GDF-15 levels with left ventricular hypertrophy (LVH) in hypertension is poorly understood. We investigate the effect of plasma GDF-15 levels on left ventricular hypertrophy (LVH) in hypertension. We measured the plasma levels of GDF-15 in 299 untreated hypertensive patients which consisted of 99 with LVH and 200 without LVH using immunoradiometric assay. All subjects were examined by the ultrasonic cardiograph to determine Left ventricular (LV) internal diameters, septal thickness, and posterior wall thickness. The associations of GDF-15 with left ventricular mass index (LVMI), LV end-systolic and –diastolic diameters, LV wall thickness, and LV ejection fraction were evaluated. We found that plasma GDF-15 levels in hypertensive patients with LVH [median 1101, 25th–75th percentiles (879–1344) ng/L] were higher than that in hypertensive patients without LVH [median 516, 25th–75th percentiles (344–640) ng/L] (P<0.001). After adjustment for traditional covariates, plasma GDF-15 levels were independently related to LVMI (R2 = 0.53; β = 0.624, P<0.001), LV interventricular septal thickness (R2 = 0.23; β = 0.087, P<0.01) and LV posterior wall thickness (R2 = 0.26; β = 0.103, P<0.05). Our cross-sectional data on a hospital-based sample indicate that plasma GDF-15 levels are associated with LVH in hypertensive patients.
Highlights
Hypertensive left ventricular hypertrophy (LVH) is the most common target organ damage, which is preclinical cardiovascular disease
It has been shown that LVH increases the risk of stroke, coronary heart disease, congestive heart failure, arrhythmias and sudden cardiac death, which is associated with cardiovascular morbidity and mortality, as well as all-cause mortality [3,4]
Characteristics of the Subjects Among the 299 hypertensive patients, a total of 99 subjects were diagnosed as LVH according to the measurement of left ventricular mass index (LVMI)
Summary
Hypertensive left ventricular hypertrophy (LVH) is the most common target organ damage, which is preclinical cardiovascular disease. Epidemiological studies show that the prevalence of LVH in hypertensive patients was about 25% to 35% in China [1,2]. It has been shown that LVH increases the risk of stroke, coronary heart disease, congestive heart failure, arrhythmias and sudden cardiac death, which is associated with cardiovascular morbidity and mortality, as well as all-cause mortality [3,4]. Hypertension is a major cause of LVH, it is influenced by other traditional cardiac risk factors such as age, sex, life style and diabetes. GDF-15 is not normally expressed in heart under physiological conditions, it increases rapidly in response to cardiovascular injury, such as pressure overload, heart failure, ischemia/reperfusion, and atherosclerosis [10,11]. Recent studies have reported that GDF-15 is emerging as an independent prognostic biomarker in patients with cardiovascular disease [12,13,14]
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