Ferreira Ricardo, Velho Tiago R, Pereira Rafael Maniés, Pedroso Dora, Draiblate Beatriz, Constantino Susana, Nobre Ângelo, Almeida Ana G, Moita Luís F, Pinto Fausto
Department of Cardiothoracic Surgery, Hospital de Santa Maria, Unidade Local de Saúde de Santa Maria, 1649-028 Lisbon, Portugal.
Cardiothoracic Surgery Research Unit, Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisbon, Portugal.
Biomolecules. 2024 Dec 13;14(12):1593. doi: 10.3390/biom14121593.
Growth Differentiation Factor 15 (GDF15) is an emerging biomarker that significantly increases during acute stress responses, such as infections, and is moderately elevated in chronic and inflammation-driven conditions. While evidence suggests that high levels of GDF15 in cardiac surgery are associated with worse outcomes, its utility as an evaluator of early postoperative complications remains unclear. This study aims to characterize the postoperative profile of GDF15 in patients undergoing isolated surgical aortic valve replacement, evaluating its association with short-term outcomes. Serum samples from patients undergoing cardiac surgery were collected preoperatively and at defined postoperative time points (1 h, 6 h, 12 h, 24 h, and 48 h) to measure GDF15 levels. GDF15 levels significantly increased after surgery, peaking at 6 h. A positive correlation was observed between GDF15 levels and both cardiopulmonary bypass and aortic cross-clamp times. Notably, patients who developed postoperative acute kidney injury (AKI) or required prolonged hemodynamic support had significantly higher GDF15 levels, with increased mechanical ventilation time and extended intensive care unit length of stay. Furthermore, GDF15 levels correlated with postoperative SOFA scores at 24 h after surgery. GDF15 may be a valuable biomarker for risk stratification and guiding therapeutic decisions in cardiac surgery patients. Higher GDF15 levels were significantly associated with prolonged hemodynamic support, postoperative AKI, and measures of illness severity.
生长分化因子15（GDF15）是一种新兴的生物标志物，在急性应激反应（如感染）期间会显著升高，在慢性和炎症驱动的情况下会适度升高。虽然有证据表明心脏手术中高水平的GDF15与更差的预后相关，但其作为早期术后并发症评估指标的效用仍不明确。本研究旨在描述接受单纯外科主动脉瓣置换术患者术后GDF15的变化情况，评估其与短期预后的关联。在心脏手术患者术前及术后特定时间点（1小时、6小时、12小时、24小时和48小时）采集血清样本，以测量GDF15水平。术后GDF15水平显著升高，在6小时达到峰值。观察到GDF15水平与体外循环时间和主动脉阻断时间均呈正相关。值得注意的是，发生术后急性肾损伤（AKI）或需要长时间血流动力学支持的患者GDF15水平显著更高，机械通气时间延长，重症监护病房住院时间延长。此外，术后24小时GDF15水平与序贯器官衰竭评估（SOFA）评分相关。GDF15可能是心脏手术患者风险分层和指导治疗决策的有价值生物标志物。较高的GDF15水平与长时间血流动力学支持、术后AKI及疾病严重程度指标显著相关。
