Hanatani Shinsuke, Izumiya Yasuhiro, Takashio Seiji, Kojima Sunao, Yamamuro Megumi, Araki Satoshi, Rokutanda Taku, Tsujita Kenichi, Yamamoto Eiichiro, Tanaka Tomoko, Tayama Shinji, Kaikita Koichi, Hokimoto Seiji, Sugiyama Seigo, Ogawa Hisao
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Heart Vessels. 2014 Mar;29(2):231-7. doi: 10.1007/s00380-013-0337-y. Epub 2013 Mar 23.
To distinguish hypertrophic cardiomyopathy (HCM) from hypertensive left ventricular hypertrophy (H-LVH) based on a morphological examination is often challenging. Growth differentiation factor 15 (GDF-15) is a novel diagnostic and prognostic biomarker for several cardiovascular diseases. In patients with LVH, GDF-15 promises to be a useful biomarker to distinguish between HCM and H-LVH. We evaluated 93 patients with H-LVH, 28 with HCM, and 28 disease control individuals. Serum GDF-15 concentrations were measured with an enzyme-linked immunosorbent assay. Circulating GDF-15 levels were significantly higher in patients with H-LVH than with HCM (P = 0.003). On the other hand, values for plasma B-type natriuretic peptide (BNP) levels were significantly lower in patients with H-LVH than with HCM (P = 0.004). Serum GDF-15 and plasma BNP levels positively correlated in patients with H-LVH but not with HCM. Multivariate logistic regression analysis revealed GDF-15 (odds ratio 12.06, confidence interval 1.85-78.77, P < 0.01) as an independent predictor of H-LVH among patients with LVH. In receiver-operating characteristic analysis, GDF-15 achieved an area under the curve of 0.70 for the identification of H-LVH. We found that GDF-15 might be a useful biomarker for discriminating HCM from H-LVH. Understanding serum GDF-15 values may have clinical utility for patients with LVH because the therapeutic strategies for treating HCM and H-LVH differ.
基于形态学检查来区分肥厚型心肌病（HCM）和高血压性左心室肥厚（H-LVH）通常具有挑战性。生长分化因子15（GDF-15）是几种心血管疾病的新型诊断和预后生物标志物。在左心室肥厚患者中，GDF-15有望成为区分HCM和H-LVH的有用生物标志物。我们评估了93例H-LVH患者、28例HCM患者和28例疾病对照个体。采用酶联免疫吸附测定法测量血清GDF-15浓度。H-LVH患者的循环GDF-15水平显著高于HCM患者（P = 0.003）。另一方面，H-LVH患者的血浆B型利钠肽（BNP）水平值显著低于HCM患者（P = 0.004）。H-LVH患者的血清GDF-15和血浆BNP水平呈正相关，而HCM患者则不然。多因素逻辑回归分析显示，GDF-15（比值比12.06，置信区间1.85-78.77，P < 0.01）是左心室肥厚患者中H-LVH的独立预测因子。在受试者工作特征分析中，GDF-15在识别H-LVH方面的曲线下面积为0.70。我们发现GDF-15可能是区分HCM和H-LVH的有用生物标志物。了解血清GDF-15值可能对左心室肥厚患者具有临床实用性，因为治疗HCM和H-LVH的策略不同。
