{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:01:36Z","timestamp":1792425696775,"version":"4.5.0"},"reference-count":19,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,1,18]],"date-time":"2021-01-18T00:00:00Z","timestamp":1610928000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Aortic valve stenosis (AS) develops with a pronounced local inflammatory response, where a variety of growth factors are involved in the process, and may have a pro-inflammatory and anti-inflammatory effect. The aim of our study was to elucidate whether circulating growth factors: growth differentiation factor 15 (GDF-15), angiopoietin-2 (Ang-2), vascular endothelial growth factor A (VEGF-A), fibroblast growth factor 2 (FGF-2), and fibroblast growth factor 21 (FGF-21) could be proposed as clinically relevant biomarkers to improve risk stratification in AS patients. Materials and Methods: AS patients were classified into three groups: 16 patients with mild AS stenosis; 19 with moderate and 11 with severe AS, and 30 subjects without AS (echocardiographically approved) were selected as a control group. GDF-15, Ang-2, VEGF-A, FGF-2, and FGF-21 were measured in plasma by the ELISA method. Results: GDF-15 levels differed significantly not only when comparing AS patients with control groups (p &lt; 0.0001), but also a statistically significant difference was achieved when comparing AS patients at a mild degree stage with control individuals. We found a strong relationship of GDF-15 levels regarding AS severity degree (p &lt; 0.0001). VEGF-A, FGF-2 and FGF-21 levels were significantly higher in AS patients than in controls, but relationships regarding the AS severity degree were weaker (p &lt; 0.02). ROC analysis of the study growth factors showed that GDF-15 might serve as a specific and sensitive biomarker of AS stenosis (AUC = 0.75, p = 0.0002). FGF-21 correlated with GDF-15, Ang-2, and FGF-2, but it did not reach the level to serve as a clinically relevant biomarker of AS stenosis. Conclusions: AS is associated with significantly increased GDF-15, VEGF-A, FGF-2, and FGF-21 levels in plasma, but only GDF-15 shows a pronounced relationship regarding AS severity degree, and GDF-15 might serve as a specific and sensitive biomarker of AS stenosis.<\/jats:p>","DOI":"10.3390\/medicina57010078","type":"journal-article","created":{"date-parts":[[2021,1,19]],"date-time":"2021-01-19T11:39:55Z","timestamp":1611056395000},"page":"78","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Prognostic Utility of Circulating Growth Factors in Aortic Valve Stenosis: A Pilot Study"],"prefix":"10.3390","volume":"57","author":[{"given":"Juris","family":"Hofmanis","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Riga Stradins University, 16 Dzirciema Str., LV-1007 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9446-0558","authenticated-orcid":false,"given":"Peteris","family":"Tretjakovs","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Riga Stradins University, 16 Dzirciema Str., LV-1007 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simons","family":"Svirskis","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Riga Stradins University, 16 Dzirciema Str., LV-1007 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gita","family":"Gersone","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Riga Stradins University, 16 Dzirciema Str., LV-1007 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dace","family":"Hofmane","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Riga Stradins University, 16 Dzirciema Str., LV-1007 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulla","family":"Rozenberga","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Riga Stradins University, 16 Dzirciema Str., LV-1007 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leons","family":"Blumfelds","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Riga Stradins University, 16 Dzirciema Str., LV-1007 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guntis","family":"Bahs","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Riga Stradins University, 16 Dzirciema Str., LV-1007 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2097-6698","authenticated-orcid":false,"given":"Aivars","family":"Lejnieks","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Riga Stradins University, 16 Dzirciema Str., LV-1007 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9991-2768","authenticated-orcid":false,"given":"Vitolds","family":"Mackevics","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Riga Stradins University, 16 Dzirciema Str., LV-1007 Riga, Latvia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,1,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1007\/s00380-013-0337-y","article-title":"Growth differentiation factor 15 can distinguish between hypertrophic cardiomyopathy and hypertensive hearts","volume":"29","author":"Hanatani","year":"2014","journal-title":"Heart Vessels"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.ejim.2011.08.022","article-title":"Growth differentiation factor-15, a novel biomarker related with disease severity in patients with hypertrophic cardiomyopathy","volume":"23","author":"Jover","year":"2012","journal-title":"Eur. 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