Growth differentiation factor 15—an early marker of abnormal function of the Fontan circuit in patients with univentricular hearts

Background In patients after the Fontan procedure, assessment of ventricular function is difficult and amino-terminal pro-B-type natriuretic peptide levels failed to be directly related to echocardiographic measures of systolic ventricular function. The aim of the study was to evaluate growth differentiation factor 15 (GDF-15), a marker of various stress pathways in the heart and extracardiac tissues. Methods Plasma GDF-15 levels were measured in 38 consecutive patients after the Fontan procedure and compared to clinical, echocardiographic, and laboratory data; liver tissue stiffness; and venous hepatic flow velocities. Results Mean GDF-15 levels were 987.2 ± 440.5 pg/mL in patients with an ejection fraction (EF)