Evaluating Growth Differentiation Factor-15 Serum Levels and Left Ventricular Dysfunction Using Different Techniques in Pediatric Hemodialysis Patients — Oak Academic Publishing
Research ArticleOpen AccessGoogle Scholar indexed
Evaluating Growth Differentiation Factor-15 Serum Levels and Left Ventricular Dysfunction Using Different Techniques in Pediatric Hemodialysis Patients
Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
,
Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
,
Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
,
Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
,
Department of Clinical Pathology, National Heart Institute, Cairo, Egypt
1 Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
2 Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
3 Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
4 Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
5 Department of Clinical Pathology, National Heart Institute, Cairo, Egypt
<b>Background:</b> The standard echocardiography is limited in detecting subclinical left ventricular (LV) dysfunction in pediatric hemodialysis patients. However, speckle-tracking echo (STE) analysis has emerged as a viable alternative. Furthermore, Growth Differentiation Factor-15 (GDF-15) is a stress-responsive biomarker generated by cardiac tissues. <b>Aim:</b> Evaluate left ventricular function using a range of echocardiography modalities and determine the most effective modality. Additionally, it seeks to quantify the diagnostic accuracy of GDF-15 as an early indicator of cardiac dysfunction in pediatric patients undergoing regular hemodialysis and explore the association between GDF-15 levels and left ventricular dysfunction. <b>Subjects and Methods:</b> An assessment of the LV functions and dimensions in a cohort of 40 pediatric patients undergoing regular hemodialysis compared to a control group of 40 healthy children. Our evaluation encompassed the utilization of GDF-15, hsCRP serum levels, conventional Echocardiography, tissue Doppler imaging (TDI), and Speckle Tracking Echocardiography (STE), in conjunction with routine laboratory investigations, to analyze the subjects post-hemodialysis (HD). <b>Results:</b> Children on hemodialysis showed significantly higher levels of GDF-15 and hsCRP. Furthermore, 67.5% of the patients displayed impaired left ventricular function as identified through conventional and TDI, while 82.5% exhibited global left ventricular strain as determined by STE. A strong correlation was found between EF% and serum cholesterol and triglyceride levels. Additionally, a notable association was discovered between GDF-15 and systolic blood pressure, left ventricular interventricular septal diameter (LVIVSD), and serum calcium levels. <b>Conclusion:</b> STE has shown its superiority over conventional and (TDI) in the early identification of LV changes in pediatric hemodialysis patients. GDF-15 is a sensitive indicator for early left ventricular dysfunction and shows a significant correlation with hypertension, left ventricular interventricular septal end-diastolic dimension (LVIVSD), and serum calcium levels.
Sulemane, S., Panoulas, V.F. and Nihoyannopoulos, P. (2017) Echocardiographic Assessment in Patients with Chronic Kidney Disease: Current Update. Echocardiography, 34, 594-602. https://doi.org/10.1111/echo.13495
Nair, V., Robinson-Cohen, C., Smith, M.R., Bellovich, K.A., Bhat, Z.Y., Bobadilla, M., et al. (2017) Growth Differentiation Factor–15 and Risk of CKD Progression. Journal of the American Society of Nephrology, 28, 2233-2240. https://doi.org/10.1681/asn.2016080919
Wallentin, L., Hijazi, Z., Andersson, U., Alexander, J.H., De Caterina, R., Hanna, M., et al. (2014) Growth Differentiation Factor 15, a Marker of Oxidative Stress and Inflammation, for Risk Assessment in Patients with Atrial Fibrillation: Insights from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTO-TLE) Trial. Circulation, 130, 1847-1858. https://doi.org/10.1161/circulationaha.114.011204
Gheissari, A., Dehghan, B., Ghaed Sharafi, B., Abedini, A., Merrikhi, A., Madihi, Y., et al. (2019) Importance of Mean Platelet Volume in Predicting Cardiac Mechanics Parameters and Carotid-Intima Media Thickness in Children with End-Stage Renal Disease and Comparison with Healthy Children. Therapeutic Apheresis and Dialysis, 23, 451-459. https://doi.org/10.1111/1744-9987.12794
Karakurt, C., Çelik, S., Selimoğlu, A., Varol, İ., Karabiber, H. and Yoloğlu, S. (2016) Strain and Strain Rate Echocardiography in Children with Wilson’s Disease. Cardiovascular Journal of Africa, 27, 307-314. https://doi.org/10.5830/cvja-2016-028
Ohno, M., Cheng, C.P. and Little, W.C. (1994) Mechanism of Altered Patterns of Left Ventricular Filling during the Development of Congestive Heart Failure. Circulation, 89, 2241-2250. https://doi.org/10.1161/01.cir.89.5.2241
Lang, R., Bierig, M., Devereux, R., Flachskampf, F., Foster, E., Pellikka, P., et al. (2006) Recommendations for Chamber Quantification. European Journal of Echocardiography, 7, 79-108. https://doi.org/10.1016/j.euje.2005.12.014
Zile, M.R. and Brutsaert, D.L. (2002) New Concepts in Diastolic Dysfunction and Diastolic Heart Failure: Part II: Causal Mechanisms and Treatment. Circulation, 105, 1503-1508. https://doi.org/10.1161/hc1202.105290
Collier, P., Phelan, D. and Klein, A. (2017) A Test in Context: Myocardial Strain Measured by Speckle-Tracking Echocardiography. Journal of the American College of Cardiology, 69, 1043-1056. https://doi.org/10.1016/j.jacc.2016.12.012
Hothi, D.K., Rees, L., Marek, J., Burton, J. and McIntyre, C.W. (2009) Pediatric Myocardial Stunning Underscores the Cardiac Toxicity of Conventional Hemodialysis Treatments. Clinical Journal of the American Society of Nephrology, 4, 790-797. https://doi.org/10.2215/cjn.05921108
Burton, J.O., Jefferies, H.J., Selby, N.M. and McIntyre, C.W. (2009) Hemodialysis-induced Repetitive Myocardial Injury Results in Global and Segmental Reduction in Systolic Cardiac Function. Clinical Journal of the American Society of Nephrology, 4, 1925-1931. https://doi.org/10.2215/cjn.04470709
Mostafa, F.A., Sad, I.A.E.S., El-shamaa, M.F., Badr, A.M., Eldayem, S.A., Ashmawy, I., et al. (2018) Left Ventricular Dysfunction by Conventional and Tissue Doppler Echocardiography in Pediatric Hemodialysis Patients: Relation with Plasma Brain Natriuretic Peptide Levels. Archives of Medical Science—Atherosclerotic Diseases, 3, 18-28. https://doi.org/10.5114/amsad.2018.73277
Amoozgar, H., Naghshzan, A., Basiratnia, M. and Ahmadipoor, M. (2018) Effect of Hemodialysis on Global and Regional Cardiac Function in Children with End-Stage Renal Disease. Iranian Journal of Kidney Diseases, 12, 48-52.
Zoccali, C., Benedetto, F.A., Tripepi, G., Mallamaci, F., Rapisarda, F., Seminara, G., et al. (2006) Left Ventricular Systolic Function Monitoring in Asymptomatic Dialysis Patients: A Prospective Cohort Study. Journal of the American Society of Nephrology, 17, 1460-1465. https://doi.org/10.1681/asn.2005111240
Langston, R.D., Presley, R., Flanders, W.D. and Mcclellan, W.M. (2003) Renal Insufficiency and Anemia Are Independent Risk Factors for Death among Patients with Acute Myocardial Infarction. Kidney International, 64, 1398-1405. https://doi.org/10.1046/j.1523-1755.2003.00200.x
Sobhy, R., Moustafa, B., Zekry, H., Hashim, R., Salah, D. and Abdelfattah, A. (2020) Echocardiographic Findings in Children with Chronic Kidney Disease. Saudi Journal of Kidney Diseases and Transplantation, 31, 1234-1244. https://doi.org/10.4103/1319-2442.308332
Galderisi, M. (2005) Diastolic Dysfunction and Diastolic Heart Failure: Diagnostic, Prognostic and Therapeutic Aspects. Cardiovascular Ultrasound, 3, Article No. 9. https://doi.org/10.1186/1476-7120-3-9
Wollert, K.C., Kempf, T. and Wallentin, L. (2017) Growth Differentiation Factor 15 as a Biomarker in Cardiovascular Disease. Clinical Chemistry, 63, 140-151. https://doi.org/10.1373/clinchem.2016.255174
Lok, S.I., Winkens, B., Goldschmeding, R., van Geffen, A.J.P., Nous, F.M.A., van Kuik, J., et al. (2012) Circulating Growth Differentiation Factor-15 Correlates with Myocardial Fibrosis in Patients with Non-Ischaemic Dilated Cardiomyopathy and Decreases Rapidly after Left Ventricular Assist Device Support. European Journal of Heart Failure, 14, 1249-1256. https://doi.org/10.1093/eurjhf/hfs120
Xue, H., Fu, Z., Chen, Y., Xing, Y., Liu, J., Zhu, H., et al. (2012) The Association of Growth Differentiation Factor-15 with Left Ventricular Hypertrophy in Hypertensive Patients. PLOS ONE, 7, e46534. https://doi.org/10.1371/journal.pone.0046534
Lajer, M., Jorsal, A., Tarnow, L., Parving, H. and Rossing, P. (2010) Plasma Growth Differentiation Factor-15 Independently Predicts All-Cause and Cardiovascular Mortality as Well as Deterioration of Kidney Function in Type 1 Diabetic Patients with Nephropathy. Diabetes Care, 33, 1567-1572. https://doi.org/10.2337/dc09-2174
Xu, J., Kimball, T.R., Lorenz, J.N., Brown, D.A., Bauskin, A.R., Klevitsky, R., et al. (2006) GDF15/MIC-1 Functions as a Protective and Antihypertrophic Factor Released from the Myocardium in Association with SMAD Protein Activation. Circulation Research, 98, 342-350. https://doi.org/10.1161/01.res.0000202804.84885.d0
Xu, X., Nie, Y., Wang, F., Bai, Y., Lv, Z., Zhang, Y., et al. (2014) Growth Differentiation Factor (GDF)-15 Blocks Norepinephrine-Induced Myocardial Hypertrophy via a Novel Pathway Involving Inhibition of Epidermal Growth Factor Receptor Transactivation. Journal of Biological Chemistry, 289, 10084-10094. https://doi.org/10.1074/jbc.m113.516278
Morciano, G., Rimessi, A., Patergnani, S., Vitto, V.A.M., Danese, A., Kahsay, A., et al. (2022) Calcium Dysregulation in Heart Diseases: Targeting Calcium Channels to Achieve a Correct Calcium Homeostasis. Pharmacological Research, 177, Article ID: 106119. https://doi.org/10.1016/j.phrs.2022.106119
Abdel-Salam, M., Ibrahim, S., Pessar, S. and Al-Morsy, E. (2017) The Relationship between Serum Homocysteine and Highly Sensitive C-Reactive Protein Levels in Children on Regular Hemodialysis. Saudi Journal of Kidney Diseases and Transplantation, 28, 483-490. https://doi.org/10.4103/1319-2442.206442
Hassanzadeh Daloee, S., Nakhaei, N., Hassanzadeh Daloee, M., Mahmoodi, M. and Barzegar-Amini, M. (2021) Evaluation of Growth Differentiation Factor-15 in Patients with or without Coronary Artery Disease. Acta Biomedica: Atenei Parmensis, 92, e2021051.
Ebrahim, D.A., Kamal, A., Ahmed, N. and Zahran, A. (2021) Assessment of Left Ventricular Function in Patients with Chronic Renal Failure Undergoing Hemodialysis. Menoufia Medical Journal, 34, 433-439. https://doi.org/10.4103/mmj.mmj_308_19