{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:29:45Z","timestamp":1790728185688,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":1064,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T00:00:00Z","timestamp":1670976000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002855","name":"Ministry of Science and Technology of the People's Republic of China","doi-asserted-by":"publisher","award":["2015BAI12B02"],"award-info":[{"award-number":["2015BAI12B02"]}],"id":[{"id":"10.13039\/501100002855","id-type":"DOI","asserted-by":"publisher"}]},{"name":"CAMS Innovation Fund for Medical Sciences","award":["2017-I2M-2-002"],"award-info":[{"award-number":["2017-I2M-2-002"]}]},{"DOI":"10.13039\/501100002855","name":"Ministry of Science and Technology of the People's Republic of China","doi-asserted-by":"publisher","award":["2015BAI12B02"],"award-info":[{"award-number":["2015BAI12B02"]}],"id":[{"id":"10.13039\/501100002855","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>There is an increasing proportion of hospitalized heart failure (HF) patients classified as HF with preserved ejection fraction (HFpEF) around the world. Growth differentiation factor 15 (GDF-15) is a promising biomarker in HFpEF prognostication; however, the majority of the existing data has been derived from the research on undifferentiated HF, whereas the studies focusing on HFpEF are still limited. This study aimed to determine the prognostic power of GDF-15 in the hospitalized patients with HFpEF in a Chinese cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We analysed the levels of serum GDF-15 in 380 patients hospitalized for acute onset of HFpEF measured by heart ultrasound at admission in a prospective cohort. The associations of GDF-15 with 1 year risk of all-cause death and 1 year HF readmission were assessed by the Cox proportional hazards model. Area under the receiver operating characteristic curves was used to compare predictive accuracy. GDF-15 was strongly correlated with 1 year HF readmission and 1 year all-cause death, with event rates of 24.8%, 40.0%, and 50.0% for 1 year HF readmission (P &amp;lt; 0.001), respectively, and with 11.2%, 13.6%, and 24.6% for 1 year all-cause death (P = 0.004) in the corresponding tertile, respectively. In the multivariate linear regression model, GDF-15 had a significantly negative correlation with haemoglobin (P = 0.01) and a positive correlation with creatinine (P = 0.01), alanine transaminase (P = 0.001), and therapy of aldosterone antagonist (P = 0.018). The univariate Cox regression model of GDF-15 showed that c-statistic was 0.632 for 1 year HF readmission and 0.644 for 1 year all-cause death, which were superior to the N-terminal pro-brain natriuretic peptide (NT-proBNP) model with c-statistics of 0.595 and 0.610, respectively. In the multivariable Cox regression model, GDF-15 tertiles independently predicted 1 year HF readmission (hazard ratio 2.25, 95% confidence interval: 1.43\u20133.54, P &amp;lt; 0.001) after adjusting for baseline Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure (ASCEND-HF) risk score, history of HF, NT-proBNP, and high-sensitivity cardiac troponin T. Compared with the model including all the adjusted variables, the model with the addition of GDF-15 improved predictive power, with c-statistic increasing from 0.643 to 0.657 for 1 year HF readmission and from 0.638 to 0.660 for 1 year all-cause death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In hospitalized patients with HFpEF, GDF-15 measured within 48 h of admission is a strong independent biomarker for 1 year HF readmission and even better than NT-proBNP. GDF-15 combined with the traditional indicators provided incremental prognostic value in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14271","type":"journal-article","created":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T02:45:48Z","timestamp":1671072348000},"page":"1025-1034","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Prognostic Value of Growth Differentiation Factors 15 in Acute Heart Failure Patients with Preserved Ejection Fraction"],"prefix":"10.1093","volume":"10","author":[{"given":"Dan","family":"Yin","sequence":"first","affiliation":[{"name":"National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College , 167 Beilishi Road, Beijing, 100037 ,","place":["People's Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofang","family":"Yan","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College , 167 Beilishi Road, Beijing, 100037 ,","place":["People's Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueke","family":"Bai","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College , 167 Beilishi Road, Beijing, 100037 ,","place":["People's Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aoxi","family":"Tian","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College , 167 Beilishi Road, Beijing, 100037 ,","place":["People's Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Gao","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College , 167 Beilishi Road, Beijing, 100037 ,","place":["People's Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Li","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College , 167 Beilishi Road, Beijing, 100037 ,","place":["People's Republic of China"]},{"name":"Fuwai Hospital, Chinese Academy of Medical Sciences , 12 Langshan Road, Nanshan District, Shenzhen ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,12,14]]},"reference":[{"key":"2026012114112237300_ehf214271-bib-0001","article-title":"AHA\/ACC\/HFSA guideline for the management of heart failure: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","author":"Heidenreich","year":"2022","journal-title":"Circulation"},{"key":"2026012114112237300_ehf214271-bib-0002","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur Heart J"},{"key":"2026012114112237300_ehf214271-bib-0003","doi-asserted-by":"crossref","first-page":"2739","DOI":"10.1016\/j.jacc.2017.09.1111","article-title":"Abdominal obesity is associated with an increased risk of all-cause mortality in patients with HFpEF","volume":"70","author":"Tsujimoto","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"2026012114112237300_ehf214271-bib-0004","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1097\/HCO.0000000000000292","article-title":"Heart failure with preserved ejection fraction in hypertension","volume":"31","author":"Teo","year":"2016","journal-title":"Curr Opin Cardiol"},{"key":"2026012114112237300_ehf214271-bib-0005","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1161\/CIRCULATIONAHA.116.025957","article-title":"The diabetic heart failure with preserved ejection fraction phenotype: is it real and is it worth targeting therapeutically?","volume":"135","author":"Lindman","year":"2017","journal-title":"Circulation"},{"key":"2026012114112237300_ehf214271-bib-0006","doi-asserted-by":"crossref","first-page":"2817","DOI":"10.1016\/j.jacc.2014.03.034","article-title":"Implications of coronary artery disease in heart failure with preserved ejection fraction","volume":"63","author":"Hwang","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"2026012114112237300_ehf214271-bib-0007","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1161\/CIRCULATIONAHA.116.022249","article-title":"Heart failure with preserved ejection fraction: a kidney disorder?","volume":"134","author":"Fang","year":"2016","journal-title":"Circulation"},{"key":"2026012114112237300_ehf214271-bib-0008","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCGENETICS.116.001633","article-title":"Inflammatory biomarkers predict heart failure severity and prognosis in patients with heart failure with preserved ejection fraction: a holistic proteomic approach","volume":"10","author":"Hage","year":"2017","journal-title":"Circ Cardiovasc Genet"},{"key":"2026012114112237300_ehf214271-bib-0009","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1002\/ejhf.414","article-title":"Circulating biomarkers of distinct pathophysiological pathways in heart failure with preserved vs. reduced left ventricular ejection fraction","volume":"17","author":"Sanders-van Wijk","year":"2015","journal-title":"Eur J Heart Fail"},{"key":"2026012114112237300_ehf214271-bib-0010","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1016\/j.jacc.2018.06.050","article-title":"Identifying pathophysiological mechanisms in heart failure with reduced versus preserved ejection fraction","volume":"72","author":"Tromp","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2026012114112237300_ehf214271-bib-0011","doi-asserted-by":"crossref","first-page":"2029","DOI":"10.1161\/CIRCULATIONAHA.120.045810","article-title":"Proteomic evaluation of the comorbidity-inflammation paradigm in heart failure with preserved ejection fraction: results from the PROMIS-HFpEF study","volume":"142","author":"Sanders-van Wijk","year":"2020","journal-title":"Circulation"},{"key":"2026012114112237300_ehf214271-bib-0012","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1007\/s00424-020-02459-1","article-title":"GDF15, an update of the physiological and pathological roles it plays: a review","volume":"472","author":"Assadi","year":"2020","journal-title":"Pflugers Arch"},{"key":"2026012114112237300_ehf214271-bib-0013","doi-asserted-by":"crossref","first-page":"2223","DOI":"10.1002\/ehf2.12621","article-title":"Growth differentiation factor 15 as mortality predictor in heart failure patients with non-reduced ejection fraction","volume":"7","author":"Mendez Fernandez","year":"2020","journal-title":"ESC Heart Fail"},{"key":"2026012114112237300_ehf214271-bib-0014","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1002\/ehf2.12301","article-title":"Towards a multi-marker prognostic strategy in acute heart failure: a role for GDF-15","volume":"5","author":"Bettencourt","year":"2018","journal-title":"ESC Heart Fail"},{"key":"2026012114112237300_ehf214271-bib-0015","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-025144","article-title":"The China Patient-centred Evaluative Assessment of Cardiac Events (PEACE) prospective heart failure study design","volume":"9","author":"Huang","year":"2019","journal-title":"BMJ Open"},{"key":"2026012114112237300_ehf214271-bib-0016","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/j.ahj.2015.04.006","article-title":"Predictors of clinical outcomes in acute decompensated heart failure: Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure outcome models","volume":"170","author":"Khazanie","year":"2015","journal-title":"Am Heart J"},{"key":"2026012114112237300_ehf214271-bib-0017","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1002\/ejhf.431","article-title":"Growth differentiation factor 15 in heart failure with preserved vs. reduced ejection fraction","volume":"18","author":"Chan","year":"2016","journal-title":"Eur J Heart Fail"},{"key":"2026012114112237300_ehf214271-bib-0018","first-page":"338","article-title":"Growth differentiation factor-15 is a useful prognostic marker in patients with heart failure with preserved ejection fraction","volume":"30","author":"Izumiya","year":"2014","journal-title":"Can J Cardiol"},{"key":"2026012114112237300_ehf214271-bib-0019","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1161\/01.RES.0000202804.84885.d0","article-title":"GDF15\/MIC-1 functions as a protective and antihypertrophic factor released from the myocardium in association with SMAD protein activation","volume":"98","author":"Xu","year":"2006","journal-title":"Circ Res"},{"key":"2026012114112237300_ehf214271-bib-0020","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1161\/CIRCULATIONAHA.109.928846","article-title":"Serial measurement of growth-differentiation factor-15 in heart failure: relation to disease severity and prognosis in the Valsartan Heart Failure Trial","volume":"122","author":"Anand","year":"2010","journal-title":"Circulation"},{"key":"2026012114112237300_ehf214271-bib-0021","article-title":"Association of serum growth differentiation factor-15 with eGFR and hemoglobin in healthy older females","volume":"31","author":"Yazawa","year":"2020","journal-title":"Int J Cardiol Heart Vasc"},{"key":"2026012114112237300_ehf214271-bib-0022","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1159\/000498959","article-title":"Association between plasma levels of growth differentiation factor-15 and renal function in the elderly: Korean frailty and aging cohort study","volume":"44","author":"Kim","year":"2019","journal-title":"Kidney Blood Press Res"},{"key":"2026012114112237300_ehf214271-bib-0023","doi-asserted-by":"crossref","first-page":"2233","DOI":"10.1681\/ASN.2016080919","article-title":"Growth differentiation factor-15 and risk of CKD progression","volume":"28","author":"Nair","year":"2017","journal-title":"J Am Soc Nephrol"},{"key":"2026012114112237300_ehf214271-bib-0024","doi-asserted-by":"crossref","DOI":"10.1155\/2020\/6162892","article-title":"Growth differentiation factor 15 in children with chronic kidney disease and after renal transplantation","author":"Thorsteinsdottir","year":"2020","journal-title":"Dis Markers"},{"key":"2026012114112237300_ehf214271-bib-0025","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.clinbiochem.2019.07.013","article-title":"Growth differentiation factor 15 is decreased by kidney transplantation","volume":"73","author":"Connelly","year":"2019","journal-title":"Clin Biochem"},{"key":"2026012114112237300_ehf214271-bib-0026","doi-asserted-by":"crossref","first-page":"4540","DOI":"10.1038\/s41388-019-0736-3","article-title":"Prostate cancer promotes a vicious cycle of bone metastasis progression through inducing osteocytes to secrete GDF15 that stimulates prostate cancer growth and invasion","volume":"38","author":"Wang","year":"2019","journal-title":"Oncogene"},{"key":"2026012114112237300_ehf214271-bib-0027","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1002\/wdev.86","article-title":"The TGFbeta superfamily signaling pathway","volume":"2","author":"Weiss","year":"2013","journal-title":"Wiley Interdiscip Rev Dev Biol"},{"key":"2026012114112237300_ehf214271-bib-0028","doi-asserted-by":"crossref","first-page":"3742","DOI":"10.1128\/MCB.20.10.3742-3751.2000","article-title":"Characterization of growth-differentiation factor 15, a transforming growth factor beta superfamily member induced following liver injury","volume":"20","author":"Hsiao","year":"2000","journal-title":"Mol Cell Biol"},{"key":"2026012114112237300_ehf214271-bib-0029","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1007\/s00125-018-4751-7","article-title":"Growth differentiation factor 15 is positively associated with incidence of diabetes mellitus: the Malm\u00f6 Diet and Cancer\u2013Cardiovascular Cohort","volume":"62","author":"Bao","year":"2019","journal-title":"Diabetologia"},{"key":"2026012114112237300_ehf214271-bib-0030","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1002\/ejhf.2424","article-title":"Pathophysiological pathways related to high plasma growth differentiation factor 15 concentrations in patients with heart failure","volume":"24","author":"Ceelen","year":"2022","journal-title":"Eur J Heart Fail"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ehf2.14271","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ehf2.14271","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/10\/2\/1025\/65051382\/eschf_10_2_1025.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/10\/2\/1025\/65051382\/eschf_10_2_1025.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T19:12:39Z","timestamp":1769022759000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/10\/2\/1025\/8304879"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,14]]},"references-count":30,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,12,14]]},"published-print":{"date-parts":[[2023,4,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.14271","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,4]]},"published":{"date-parts":[[2022,12,14]]},"assertion":[{"value":"2022-06-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}