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. 2015 Nov 15;8(11):21201-7.
eCollection 2015.

Growth differentiation factor-15 (GDF-15), novel biomarker for assessing atrial fibrosis in patients with atrial fibrillation and rheumatic heart disease

Yong-Ming Zhou  1 , Ming-Jiang Li  2 , Yan-Li Zhou  2 , Le-Le Ma  2 , Xin Yi  2
Affiliations

Growth differentiation factor-15 (GDF-15), novel biomarker for assessing atrial fibrosis in patients with atrial fibrillation and rheumatic heart disease

Yong-Ming Zhou et al. Int J Clin Exp Med. .

Abstract

Objective: Growth differentiation factor-15 (GDF-15) has been identified as a strong biomarker of cardiovascular diseases; however, no evidence are available concerning the relationship of GDF-15 and atrial fibrosis in patients with atrial fibrillation (AF) and rheumatic heart disease (RHD).

Methods: Twenty patients with rheumatic heart disease were divided into two groups, 10 cases with AF and 10 cases with sinus rhythm (SR). Clinical data and blood samples were collected; left atrial appendage was taken by the surgeon in the process of valve replacement. Masson stained sections and mRNA levels of cardiac fibrosis biomarkers were used to determine the level of cardiac fibrosis, the expression level of GDF-15 was evaluated via immunohistochemistry, enzyme-linked immunosorbent assay (ELISA) and real-time polymerase chain reaction (PCR).

Results: Compared with SR group, more collagen deposited in the atrial tissue of AF group. The distribution of GDF-15 in the AF group was significantly higher than SR group (P<0.05). In addition, plasma GDF-15 level and mRNA level of GDF-15 in atrial tissue of AF showed the same trend as the result of immunohistochemistry. After linear correlation analysis, the expression level of GDF-15 was found to be positively related to the degree of cardiac fibrosis.

Conclusion: GDF-15 might involve in the development and maintenance of atrial fibrosis in patients with atrial fibrillation and rheumatic heart disease, and GDF-15 could be used as a novel biomarker to evaluate myocardial fibrosis in the future.

Keywords: Growth differentiation factor-15; atrial fibrillation; atrial fibrosis; rheumatic heart disease.

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Figures

Figure 1
Figure 1
Accumulated collagen deposited in the myocardial interstitial of AF patients with RHD. A. Masson staining in right atrium of SR and AF patients with rheumatic heart disease (Representative image, collagen was stained for blue). B. Quantification of the total collagen volume in SR and AF patients with rheumatic heart disease. C. The mRNA levels of CTGF, Collagen I and III in the atrial tissues of SR and AF patients with rheumatic heart disease. *P<0.05 vs. SR group.
Figure 2
Figure 2
Elevated GDF-15 levels in plasma and myocardiac tissues of AF patients with RHD. A. Level of GDF-15 in plasma was significantly increased in AF patients with rheumatic heart disease. B. Representative immunohistochemistry staining images of GDF-15 in SR and AF patients with rheumatic heart disease. C. The mRNA levels of GDF-15 in the atrial tissues of SR and AF patients with rheumatic heart disease. *P<0.05 vs. SR group.
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