Predictive effects of serum levels of GDF11 and Copeptin in the therapeutic effects and death risk of congestive heart failure patients treatment with Nesiritide

ObjectiveTo investigaste the predictive effects of serum levels of growth differentiation factor 11 (GDF11) and Copeptin in the therapeutic effects and death risk of congestive heart failure(CHF) patients treated with Nesiritide.

MethodsA total of 156 CHF patients were selected, and treated with Nesiritide.The NYHA cardiac function grade, ECG QRS width, left ventricular end-diastolic diameter(LVEDD), left ventricular ejection fraction(LVEF) and serum levels of GDF11 and Copeptin were compared before and after treatment.The patients were followed up to October 2021, and divided into the survival group and death group according to their prognosis.The univariate and multivariate logistic regression analysis were used to analyze the baseline data of two groups, and the receiver operating characteristic curve(ROC) was used to analyze the value of serum GDF11 and Copeptin in predicting the risk of death.

ResultsIn NYHA cardiac function classification before treatment, 48 cases were grade Ⅱ, 36 cases were grade Ⅲ and 72 cases were grade Ⅳ.In NYHA cardiac function grading after treatment, 29 cases were grade Ⅰ, 67 cases were grade Ⅱ, 43 cases were grade Ⅲ and 17 cases were grade Ⅳ, the cardiac function were significantly improved(P < 0.01).After treatment, the QRS width and LVEDD values were significantly lower than those before treatment(P < 0.01), the LVEF values were significantly higher than those before treatment(P < 0.01), and the GDF11 and Copeptin values were significantly lower than those before treatment (P < 0.01).The results of Pearson correlation analysis showed that the serum levels of GDF11 and Copeptin were positively correlated with LVEDD(r=0.291 and 0.268) and QRS width(r=0.247 and 0.222) (P < 0.01), and negative correlation with LVEF(r=-0.310 and -0.261) (P < 0.01).The patients were followed up to October 2021, and the median follow-up time was (29.23±3.00) months.The indexes of hs-CRP, TNF-α, GDF11 and Copeptin in the death group were higher than those in survival group(P < 0.01).The results of logistic regression analysis showed that the serum levels of GDF11 (OR=1.702, 95%CI: 1.348-2.150) and serum Copeptin(OR=2.166, 95%CI: 1.458-3.219) were the influencing factors of the death of CHF patients(P < 0.01).According to the ROC curve, the critical value of serum GDF11 diagnosis was 765.44 ng/mL, the corresponding sensitivity, specificity and AUC were 70.37%, 70.16%, and 0.785(95%CI: 0.730-0.839), respectively.The critical value of serum Copeptin diagnosis was 26.29 pmol/L, the corresponding sensitivity, specificity and AUC were 59.26%, 59.68% and 0.635(95%CI: 0.571-0.700), respectively.The sensitivity, specificity and AUC of the combined diagnosis were 88.89%, 78.23% and 0.878(95%CI: 0.831-0.908), resdpectively, which were significantly higher than those of GDF11 and Copeptin alone(P < 0.05).

ConclusionsThe treatment of CHF with Nesiritide is effective, which can effectively improve the cardiac function, and reduce the serum levels of GDF11 and Copeptin.The serum GDF11 and Copeptin are the independent influencing factors of CHF death, and which can improve the diagnostic efficiency of predicting death in CHF patients through combined diagnosis.