Elevated levels of GDF15 and sST2 were strongly correlated with atrial high rate episodes burden in patients with DDD pacemakers (r=0.880 and r=0.792, respectively; p=0.0001).
Case-Control (n=86)
Are elevated levels of GDF15 and sST2 associated with atrial high rate episodes in patients with DDD pacemakers?
Elevated levels of GDF15 and sST2 are strongly correlated with atrial high rate episode burden in patients with DDD pacemakers, suggesting their potential utility in identifying patients at risk for thromboembolism.
Effect estimate: r = 0.880 for GDF15; r = 0.792 for sST2
p-value: p=0.0001
Abstract Background Atrial high rate episodes (AHREs) are associated with increased risks of thromboembolism and cardiovascular mortality. Growth differentiation factor 15 (GDF-15), a member of the transforming growth factor-β (TGF-β) family, is a promising predictor of atrial fibrillation (AF) which is also involved in cell proliferation, differentiation and apoptosis. Suppression of tumorigenicity 2 (ST2) is a member of the interleukin-1 receptor family and is associated with the development of inflammation, oxidative stress and fibrosis in cardiac tissue. Fibroblast growth factor 23 (FGF-23) activates the TGF-β signaling pathway and is thought to have an effect on fibrotic changes in the left atrium in AF. Purpose This study aims to determine the relationship between clinical characteristics, echocardiograhic variables, GDF15, FGF23, sST2, and AHREs. Methods Subjects aged 43-79 years who presented between May 2024 and December 2024, had a history of DDD pacemaker implantation due to complete or high grade AV block, had 24 h Holter ECG monitoring for suspected arrhythmias were included. 45 consecutive subjects who had AHREs and 41 consecutive subjects who had no AHREs during follow-up device checks or on Holter monitoring were enrolled (Table 1). AHRE was defined as the presence of an atrial tachyarrhythmia with an atrial rate 175 bpm lasting for at least 5 minutes (Table 2). Venous blood samples were collected for GDF15, FGF23, and sST2. Comprehensive echocardiographic examination was performed. Clinical characteristics, routine blood tests, and medications were collected from electronic records. Spearman correlation analysis was used to detect the relationship between variables. We performed univariate and multivariate linear regression analyses with AHREs burden as the dependent variable. Results The mean age of the patient group was 68.89 ± 8.32 years (51% women). Age, LA diameter, IVS and PW thickness, LVESD, LV mass index, E/é ratio, LAVI, sPAP, and RA area were larger in patients than controls; septal é, lateral é, TAPSE, TAPSE/sPAP ratio, and eGFR were smaller in patients than controls (Table 1). The levels of GDF15 and sST2 in the patient group were 9.06 ± 28.79 ng/L and 628.19 ± 1887.58 ng/L vs 2.26 ± 4.52 ng/L and 7.44 ± 10.76 ng/L in controls, respectively (p=0.0001). According to the multivariate regression analysis, GDF15 (p=0.03) and sST2 (p=0.0001) were predictors of AHREs (Table 2). There were strong positive correlations between AHREs burden and GDF15 (r = 0.880, p = 0.000), and sST2 (r = 0.792, p = 0.000). Conclusions GDF15 and sST2 were associated with AHREs burden. In the multivariate analyses, GDF15 and sST2 were predictors of AHREs. Both GDF15 and sST2 levels could be useful in the determination of which patients should be closely followed up in order to prevent the development of thromboembolism.Table 1
TÜRKÖZ et al. (Sat,) conducted a case-control in Atrial high rate episodes (n=86). GDF15 and sST2 vs. Controls without AHREs was evaluated on Atrial high rate episodes (AHREs) burden (r = 0.880 for GDF15; r = 0.792 for sST2, p=0.0001). Elevated levels of GDF15 and sST2 were strongly correlated with atrial high rate episodes burden in patients with DDD pacemakers (r=0.880 and r=0.792, respectively; p=0.0001).