Correlations between serum GDF-11 and TSG-6 levels and risk of heart failure in patients with dilated cardiomyopathy
Objective To explore the correlations between serum growth differentiation factor 11(GDF-11)and tumor necrosis factor α-stimulating gene-6(TSG-6)levels and the risk of heart failure in patients with dilated cardiomyopathy(DCM).Methods A total of 174 patients with DCM admitted to the People's Hospital of Longhua,Shenzhen from August 2019 to May 2022 were retrospectively selected.There were 87 males and 87 females,aged 50 to 82 years.According to whether the patients were complicated with heart failure within 1 year,they were divided into a heart failure group(84 cases)and a non-heart failure group(90 cases).Serum GDF-11 and TSG-6 levels were measured in all the patients.The clinical data of the two groups were collected and were compared.Multivariate logistic regression analysis was used to analyze the influencing factors of heart failure in DCM patients.The predictive values of serum GDF-11 and TSG-6 levels for heart failure in DCM patients were analyzed by the receiver operating characteristic curve(ROC).Kaplan-Meier(KM)curve was used to analyze the correlations between GDF-11 and TSG-6 levels and heart failure.x2 test and independent sample t test were performed.Results The levels of GDF-11 and TSG-6 in the heart failure group were higher than those in the non-heart failure group(both P＜0.05).There were no statistically significant differences in the gender,body mass index(BMI),combined underlying diseases,smoking history,drinking history,systolic blood pressure,diastolic blood pressure,triglyceride(TG),or total cholesterol(TC)between the two groups(all P＞0.05).The levels of age,heart rate(HR),brain natriuretic peptide(BNP),alanine aminotransferase(ALT),and serum creatinine(Scr)in the heart failure group were higher than those in the non-heart failure group,while the level of left ventricular ejection fraction(LVEF)was lower than that in the non-heart failure group(all P＜0.05).Binary logistic regression analysis showed that LVEF level(OR=0.487,95％CI:0.289-0.818)was an independent protective factor for heart failure in DCM patients,and BNP(OR=6.437,95％CI:1.793-23.104),GDF-11(OR=3.582,95％CI:1.825-7.029),and TSG-6 levels(OR=5.421,95％CI:2.329-12.617)were independent risk factors for heart failure in DCM patients(all P＜0.05).ROC analysis results showed that the sensitivities of GDF-11,TSG-6,and their combination in predicting DCM heart failure were 72.60％,73.80％,and 90.50％,the specificities were 71.10％,75.60％,and 87.80％,and the areas under the curves were 0.794,0.818,and 0.948,respectively(all P＜0.05).There was a statistically significant difference in the KM curve between the patients with high expression of GDF-11 and the patients with low expression(P＜0.05).There was a statistically significant difference in the KM curve between the patients with high expression of TSG-6 and the patients with low expression(P＜0.05).Conclusions Serum GDF-11 and TSG-6 are related to the risk of heart failure in DCM patients,and are independent risk factors affecting the occurrence of heart failure in DCM patients.The combined detection of GDF-11 and TSG-6 levels can better predict the occurrence of heart failure in DCM patients.
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