GDF-15 level independently inversely correlates with left atrial reservoir strain in AF patients, reflecting atrial stiffness and myocardial stress (CC -0.208, p=0.004).
Do GDF-15 levels correlate with echocardiographic parameters of atrial cardiomyopathy in patients with atrial fibrillation?
GDF-15 is independently associated with left atrial reservoir strain, suggesting its potential as a biomarker for atrial stiffness and myocardial stress in patients with atrial fibrillation.
Tasa de eventos absoluta: 0% vs 0%
Abstract Background Growth differentiation factor 15 (GDF-15) is a well-established biomarker for heart failure, bleeding, stroke and mortality in atrial fibrillation (AF). Atrial cardiomyopathy describes electrophysiological, structural, contractile, or architectural changes in the atrium. It is associated with atrial arrythmias, atrial failure, thrombogenesis and plays a key role in the development of AF in many patients. Purpose This study aimed to assess the correlation between GDF-15 levels and echocardiographic parameters for atrial cardiomyopathy in patients with AF. Methods In this cohort study patients with AF receiving oral anticoagulation therapy were prospectively enrolled and followed. GDF-15 levels were assessed from blood samples collected at the time of inclusion. Left atrial reservoir strain (LASr), left atrial (LA) diameter and LA volume were measured in the apical 4-chamber view. Results In total, we analysed the data of 292 patients with AF and followed them for a median time of 2.7 years (IQR 1.4-3.3). The median age was 77 years (IQR 66-81 years) with 37.3 % (n=109) of the participants being female. Patients were categorized into GDF-15 tertiles. With increasing GDF-15 levels there was a stepwise increase in patients with permanent AF (n=4 4.1% in the 1st tertile vs n=20 20.6% in the 3rd tertile, p = 0.004). In 190 patients an echocardiography was performed at baseline. Patients in the highest GDF-15 tertile had a lower LASr (1st tertile 18.9% 11.5-27.1% vs 3rd tertile 10.4% 6.9-14.0%, p 0.001), larger LA diameter (1st tertile 54.5mm 49.7-56.2mm vs 3rd tertile 57.2mm 53.0-62.2mm, p = 0.008) and larger LA volume (1st tertile 36.6mL/m2 IQR 26.1-45.5mL/m2 vs 3rd tertile 45.0 mL/m2 IQR 38.0-48.0 mL/m2, Figure 1). GDF-15 showed a strong inverse correlation with the LASr (correlation coefficient CC -0.353, p 0.001, Figure 2). This correlation remained significant after adjusting for age, sex and NT-proBNP in a partial correlation analysis (CC -0.208, p = 0.004). LA diameter and LA volume also showed a significant correlation with GDF-15 (LA diameter CC 0.256, p 0.001, LA volume CC 0.321, p 0.001). However, these results did not remain significant after adjustment (LA diameter CC 0.095, p-value 0.195, LA volume 0.094, p = 0.201). Conclusion The LA strain is a valuable marker for atrial cardiomyopathy, mirroring AF burden and predicting adverse outcomes such as thrombus formation, stroke and mortality. Our findings demonstrate that GDF-15 is independently associated with the LA strain, highlighting its potential as an accessible biomarker for atrial stiffness and atrial myocardial stress in patients with advanced atrial cardiomyopathy.Patient characteristics Correlation coefficients
Baumer et al. (Sat,) reported a other. GDF-15 level independently inversely correlates with left atrial reservoir strain in AF patients, reflecting atrial stiffness and myocardial stress (CC -0.208, p=0.004).