847 CONCENTRATIONS OF GROWTH DIFFERENTIATION FACTOR 15 AND LEFT VENTRICULAR FUNCTION IN SURVIVORS FROM HODGKIN LYMPHOMA TREATED WITH ANTHRACYCLINE-CONTAINING CHEMOTHERAPY


 
 
 Recent studies have shown that the concentrations of growth differentiation factor 15 (GDF-15) increase after anthracycline administration and may be associated with cardiotoxicity during or shortly after treatment. The relation of GDF-15 with late-onset cardiotoxicity has far less been studied.
 
 
 
 We examined GDF-15 levels across the spectrum of left ventricular (LV) function in a single-center cohort of adult patients who had received curative chemotherapy for Hodgkin lymphoma and underwent comprehensive cardiologic assessment including transthoracic echocardiography (TTE) as part of long-term follow-up. Plasma GDF-15 was measured by enzyme-linked immunosorbent assay, and the concentrations between TTE phenotypes were compared by unpaired Student's t test. The correlation between GDF-15 values and echocardiographic parameters was investigated by linear regression.
 
 
 
 35 (18 males, 51%) patients were evaluated a median of 47 months (IQR 24-67) after doxorubicin-containing chemotherapy. The median age at the end of treatment and at the time of TTE was 35 years (IQR 28-50) and 40 years (IQR 32-56), respectively. All subjects had received ABVD with or without rituximab as a first-line treatment; 2 (6%) had also received mediastinal irradiation, 6 (17.4%) a second-line therapy, 2 (8.7%) a third-line treatment, and 8 (17.4%) had ultimately undergone bone marrow transplantation. None had a history of heart disease or atrial fibrillation, nor NYHA class ≥II. Body mass index was 24 ± 5 Kg/m2. Seven (20%) patients had hypertension, 9 dyslipidemia (26%), and 2 (6%) diabetes; 28 (80%) were prior or current smoker. Mean GDF-15 was 1132,9 ± 485,0 pg/mL. LV ejection fraction (LVEF) was always >50%; 3 (9%) subjects had global longitudinal strain (GLS) < -18%. Moreover, 7 (20%) had mild or moderate diastolic dysfunction, as defined by E/A ratio <1 or a pseudonormal mitral inflow pattern, respectively. There was no significant relation between GDF-15 and LVEF or GLS values. By contrast, GDF-15 levels were higher in patients with diastolic dysfunction than in those without. Moreover, GDF-15 concentrations correlated with E/A and E/e’ ratios, estimated pulmonary capillary wedge pressure, and estimated systolic pulmonary artery pressure (Figure).
 
 
 
 Our results suggest that GDF-15 tracks with LV diastolic, rather than systolic, dysfunction years after anthracycline chemotherapy.
