title: Growth-differentiation Factor-15 and Tissue Doppler Imaging in Detection of Anthracycline-induced Cardiomyopathy During Therapy of Childhood Cancers.
abstract: OBJECTIVE
  The aim of this study was to evaluate the importance of growth-differentiation factor-15 (GDF-15) levels and tissue Doppler imaging (TDI) in the early detection of anthracycline-induced cardiomyopathy during the treatment of childhood cancers.
  
  
  METHODS
  Twenty patients (13 males and 7 females) newly diagnosed with childhood cancer whose treatment protocol included anthracycline were included in the study. Echocardiography, including M-mode, pulse Doppler, and TDI, was performed after the first anthracycline treatment at cumulative doses of 100, 200, and 300 mg/m and at least 6 months after the last treatment. GDF-15 and troponin-I were also measured at these time points.
  
  
  RESULTS
  The median age of the patients was 14 years (range, 3 to 18 y). The median cumulative anthracycline dose was 220 mg/m (range, 60 to 400 mg/m). Conventional pulse wave and pulse wave tissue Doppler methods revealed significant differences in the right ventricular myocardial performance indices of the patients who received cumulative anthracycline doses of 300 mg/m compared with their indices at least 6 months after the last treatment. The serum GDF-15 levels after the cumulative anthracycline dose of 200 mg/m were also higher than the patients' pretreatment levels.
  
  
  CONCLUSIONS
  Doppler/TDI and GDF-15 levels may be used in the early determination of anthracycline-induced cardiomyopathy during the treatment of childhood cancers.
authors.affiliation: Departments of *Pediatrics ‡Biochemistry ∥Pediatric Cardiology §Pediatric Hematology and Oncology, Faculty of Medicine, Selcuk University †Department of Pediatric Cardiology, Konya Education and Research Hospital, Konya, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Kaya
authors.forename: Derya
authors.initials: D
authors.lastname: Arslan
authors.forename: Husamettin
authors.initials: H
authors.lastname: Vatansev
authors.forename: Dogan
authors.initials: D
authors.lastname: Kose
authors.forename: Derya
authors.initials: D
authors.lastname: Cimen
authors.forename: Fikret
authors.initials: F
authors.lastname: Akyurek
authors.forename: Bulent
authors.initials: B
authors.lastname: Oran
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Koksal
mesh_terms: D000293:Adolescent; D018943:Anthracyclines / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D009202:Cardiomyopathies / Q000139:chemically induced / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D055436:Growth Differentiation Factor 15 / Q000097:blood*; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000188:drug therapy*
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents; D015415:Biomarkers; C526140:GDF15 protein, human; D055436:Growth Differentiation Factor 15