Introduction: GDF-15 is known to provide prognostic information in patients with chronic heart
failure. Patients with cirrhosis of the liver (LC) may also exhibit cardiac dysfunction
that can be detected echocardiographically or by measuring the natriuretic peptide
NT-proBNP. The aim of the study was to investigate the clinical value of GDF-15 in
patients with chronic liver disease.
Methods: Concentrations of NT-proBNP and GDF-15 were measured in 31 patients with LC and 33
patients with liver fibrosis (LF) and compared to clinical and echocardiographic parameters.
Results: Mean levels of NT-proBNP and GDF-15 were 407.1±553.4 pg/ml and 8394.1±12664.5 pg/ml
in patients with LC as compared to 59.5±51.3 pg/ml and 1359.5±821.1 pg/ml in patients
with LF (p<0.001). Left ventricular diastolic dysfunction (LVDD) was diagnosed
in 25/31 (80.6%) patients with LC and 8/33 (24.2%) patients with LF (p<0.001).
In patients with LVDD, concentrations of NT-proBNP and GDF-15 were significantly higher
as compared to patients without LVDD (p<0.01), however, NT-proBNP but not GDF-15
levels raised with the extent of LVDD. According to ROC analysis the extent of liver
fibrosis was predicted best by GDF-15 with an area under the curve (AUC) of 0.93 as
compared to NT-proBNP with an AUC of 0.76 or Apri-score with an AUC of 0.87.
Conclusions: 1. Patients with LC show significantly elevated concentrations of NT-proBNP and GDF-15
as compared to patients with LF. 2. In contrast to NT-proBNP, GDF-15 levels seem to
reflect the extent of liver fibrosis rather than LVDD in patients with chronic liver
disease.
GDF-15 - Liver fibrosis - NT-proBNP - cardiac dysfunction - liver cirrhosis
