Li G et al. – This study investigated plasma growth differentiation factor–15 (GDF–15) levels in pediatric patients with pulmonary arterial hypertension secondary to congenital heart disease (PAH–CHD) and assessed its association with hemodynamic parameters. Plasma GDF–15 levels were significantly elevated in patients with PAH–CHD (n = 46; median 1415 ng/L) compared with patients with CHD without PAH (n = 39; 890.6 ng/L). Functional class, uric acid, N–terminal pro–B–type natriuretic peptide (NT–proBNP), pulmonary artery systolic pressure, mean pulmonary artery pressure, pulmonary blood flow/systemic blood flow and pulmonary vascular resistance, and lower mixed venous oxygen saturation (Svo2) were positively related to elevated levels of plasma GDF–15. NT–pro BNP was not inferior to GDF–15, with respect to the diagnostic power. Thus, plasma GDF–15 levels can be considered as a surrogate marker for pediatric PAH–CHD.