Abstract: Objective To detect the changes of serum growth differentiation factor 15 (GDF-15) and type Ⅰ procollagen carboxy terminal peptide (PⅠCP) and type Ⅲ procollagen amino terminal peptide (PⅢNP) in patients with heart failure, and to analyze the correlation between GDF-15, PⅠCP and PⅢNP, and to explore the guiding role of GDF-15 in ventricular remodeling in patients with heart failure. Methods A total of 219 patients with heart failure were enrolled. Patients were divided into heart function Ⅰ grade (n= 58), Ⅱ grade (n=39), Ⅲ grade (n=47), and Ⅳ grade (n=75) groups in accordance with New York Heart Association (NYHA). According to left ventricular ejection fraction (LVEF), the heart failure patients were divided into heart failure with reduced LVEF group (LVEF＜ 0.45, n=69) and heart failure with preserved LVEF group (LVEF≥0.45, n=150). And 32 healthy subjects were chosen as the control group. Serum levels of GDF-15, PⅠCP, and PⅢNP were measured by ELISA. Left ventricular end-diastolic diameter (LVEDD), left atrial (LA), interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT), and left ventricular ejection fraction (LVEF) were measured by echocardiography. The left ventricular mass index (LVMI) was calculated. And also the correlation between serum GDF-15 and PⅠCP, PⅢNP, NT-proBNP, LVEDD, LA, LVMI and LVEF were analyzed in patients with heart failure. Results Serum levels of GDF-15, PⅠCP, PⅢNP and NT-proBNP were significantly elevated in patients with heart failure (P＜ 0.05), and increased with the increasing NYHA classification. The serum levels of LA, LVEDD, LVMI, NT-proBNP, GDF-15, PⅠCP and PⅢNP were increased in turn in control group, HFpEF group and HFrEF group (P＜0.05). Serum GDF-15 levels were positively correlated with PⅠCP, PⅢNP, NT-proBNP, LA, LVEDD, and LVMI in patients with heart failure (rs=0.549, 0.533, 0.539, 0.393, 0.403, 0.485, P＜0.01), and negatively correlated with LVEF (rs=-0.568, P＜0.01). Conclusion Serum GDF-15 is associated with the severity of heart failure and may reflect ventricular remodeling in patients with heart failure.

Key words: heart failure, ventricular remodeling, growth differentiation factor 15, C-terminal propeptide of collagen type Ⅰ, Nterminal propeptide of collagen type Ⅲ