将GDF-15整合到急性心力衰竭的多标志物评估中：诊断和预后意义
Integrating GDF-15 into Multimarker Assessment of Acute Heart Failure: Diagnostic and Prognostic Implications.
摘要(中文译文)
急性心力衰竭（AHF）是全球范围内住院和死亡的主要原因。尽管基于生物标志物的评估取得了进展，但在日常临床实践中，准确的诊断和预后分层仍然具有挑战性。生长分化因子-15（GDF-15）已成为一种与心力衰竭（HF）晚期疾病特征、不良结局及复杂潜在病理生理过程相关的生物标志物。本研究旨在探讨GDF-15在急性环境中的诊断和预后价值，并评估其在多标志物评估策略中的增量作用。在这项前瞻性队列研究中，共纳入60例因AHF住院的患者和42例对照受试者。入院时测定循环中GDF-15、N末端B型利钠肽原（NT-proBNP）和高敏心肌肌钙蛋白I（hs-cTnI）的水平。采用受试者工作特征（ROC）分析和多变量logistic回归评估诊断效能。针对院内、短期和一年死亡率评估预后价值，包括多标志物模型。GDF-15水平在AHF中显著升高，并表现出良好的诊断特征，具有高特异度和可接受的敏感度。当纳入多变量诊断模型时，GDF-15在已确立的心脏生物标志物之外提供了显著的附加价值。在预后方面，单一生物标志物的长期区分能力有限，而纳入GDF-15的多标志物方法改善了短期死亡率预测，并增强了NT-proBNP水平显著升高患者的一年风险分层。GDF-15在AHF中提供了独立的诊断和预后信息，并增强了用于全面患者评估的多标志物策略，支持其作为补充性生物标志物整合到当代AHF评估中。
Abstract
Acute heart failure (AHF) is a leading cause of hospitalization and mortality worldwide. Despite advances in biomarker-based evaluation, accurate diagnostic and prognostic stratification remains challenging in everyday clinical practice. Growth differentiation factor-15 (GDF-15) has emerged as a biomarker associated with advanced disease profiles, poor outcomes and complex underlying pathophysiological processes in heart failure (HF). This study aimed to investigate the diagnostic and prognostic value of GDF-15 in the acute setting and to evaluate its incremental role within multimarker assessment strategies. In this prospective cohort study, 60 patients hospitalized with AHF and 42 control subjects were enrolled. Circulating levels of GDF-15, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and high-sensitivity cardiac troponin I (hs-cTnI) were measured at admission. Diagnostic performance was assessed using receiver operating characteristic (ROC) analysis and multivariable logistic regression. Prognostic value was evaluated for in-hospital, short-term, and one-year mortality, including multimarker models. GDF-15 levels were significantly elevated in AHF and demonstrated a favorable diagnostic profile, with high specificity and acceptable sensitivity. When integrated into multivariable diagnostic models, GDF-15 added significant value beyond established cardiac biomarkers. For prognosis, standalone biomarkers showed limited long-term discrimination, whereas multimarker approaches incorporating GDF-15 improved short-term mortality prediction and enhanced one-year risk stratification in patients with markedly elevated NT-proBNP levels. GDF-15 provides independent diagnostic and prognostic information in AHF and enhances multimarker strategies for comprehensive patient assessment, supporting its integration as a complementary biomarker in contemporary AHF evaluation.
如何引用
AMA
Bianca-Ana Dmour, Minerva Codruta Badescu, Daniela Constantinescu, Cristina Tuchiluș, Corina Maria Cianga, Gina Eosefina Botnariu, et al. Integrating GDF-15 into Multimarker Assessment of Acute Heart Failure: Diagnostic and Prognostic Implications.. Life (Basel, Switzerland). 2026; doi:10.3390/life16030503.
APA
Bianca-Ana Dmour, Minerva Codruta Badescu, Daniela Constantinescu, Cristina Tuchiluș, Corina Maria Cianga, Gina Eosefina Botnariu, et al (2026). Integrating GDF-15 into Multimarker Assessment of Acute Heart Failure: Diagnostic and Prognostic Implications.. Life (Basel, Switzerland). https://doi.org/10.3390/life16030503
GB/T 7714
Bianca-Ana Dmour, Minerva Codruta Badescu, Daniela Constantinescu, Cristina Tuchiluș, Corina Maria Cianga, Gina Eosefina Botnariu, et al. Integrating GDF-15 into Multimarker Assessment of Acute Heart Failure: Diagnostic and Prognostic Implications.[J]. Life (Basel, Switzerland), 2026 doi:10.3390/life16030503.
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