GDF-15 is increased during early reperfusion following aortic valve replacement.

Objectives. To examine the circulating levels of Growth differentiation factor 15 (GDF-15) and Interleukin 18 (IL-18) in relation to ischemia and early reperfusion, and cardioplegia type during isolated aortic valve replacement (AVR). Design. Thirty consecutive patients operated for aortic stenosis with AVR at Oslo University Hospital, Ulleval, were included in the study. The patients were randomized into two groups, receiving either cold blood or crystalloid cardioplegia. Samples from both the radial artery and coronary sinus were analyzed before cardiac ischemia, and after 5 and 20 minutes of reperfusion. Results. Radial artery and coronary sinus plasma GDF-15 were significantly elevated after 5 and 20 minutes of reperfusion in both cardioplegia groups. In the total group of thirty patients, this represented an increase of 31% and 55% in the radial artery and an increase of 27% and 40% in the coronary sinus after 5 and 20 minutes of reperfusion respectively. IL-18 increased after 20 minutes of reperfusion in the crystalloid cardioplegia group only. No veno-arterial differences were detected during reperfusion. Conclusions. Plasma levels of GDF-15 were significantly elevated after 5 and 20 minutes of myocardial reperfusion during AVR. Plasma levels of IL-18 were elevated after 20 minutes, but only when using crystalloid cardioplegia.