The role of the Tei index in assessing for cardiotoxicity from anthracycline chemotherapy: a systematic review

Background: Anthracycline agents are known to be effective in treating tumors and hematological malignancies. Although these agents improve survival, their use is associated with cardiotoxic effects, which most commonly manifests as left ventricular systolic dysfunction (LVSD). As such, guidelines r...

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Main Authors: Sadie Bennett, Arzu Cubukcu, Chun Wai Wong, Timothy Griffith, Cheryl Oxley, Diane Barker, Simon Duckett, Duwarakan Satchithananda, Ashish Patwala, Grant Heatlie, Chun Shing Kwok
Format: Article
Language:English
Published: BMC 2021-05-01
Series:Echo Research and Practice
Subjects:
Online Access:https://erp.bioscientifica.com/view/journals/echo/8/1/ERP-20-0013.xml
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author Sadie Bennett
Arzu Cubukcu
Chun Wai Wong
Timothy Griffith
Cheryl Oxley
Diane Barker
Simon Duckett
Duwarakan Satchithananda
Ashish Patwala
Grant Heatlie
Chun Shing Kwok
author_facet Sadie Bennett
Arzu Cubukcu
Chun Wai Wong
Timothy Griffith
Cheryl Oxley
Diane Barker
Simon Duckett
Duwarakan Satchithananda
Ashish Patwala
Grant Heatlie
Chun Shing Kwok
author_sort Sadie Bennett
collection DOAJ
description Background: Anthracycline agents are known to be effective in treating tumors and hematological malignancies. Although these agents improve survival, their use is associated with cardiotoxic effects, which most commonly manifests as left ventricular systolic dysfunction (LVSD). As such, guidelines recommend the periodic assessment of left ventricular ejection fraction (LVEF). However, as diastolic dysfunction likely proceeds systolic impairment in this setting, the role of Tei index may offer additional benefit in detecting subclinical LVSD. Methods: We conducted a systematic review to investigate the evidence for the use of Tei index in assessing subclinical cardiotoxicity in patients receiving anticancer agents. A search of Medline and EMBASE was performed and relevant studies were reviewed and narratively synthesized. Results: A total of 13 studies were included with a total of 800 patients (mean age range 46–62 years, percentage of male participants ranged from 0–86.9%). An increase in Tei index was observed in 11 studies, which suggested a decline in cardiac function following chemotherapy. Out of these, six studies indicated that the Tei index is a useful parameter in predicting cardiotoxic LVSD. Furthermore, five studies indicated Tei index to be superior to LVEF in detecting subclinical cardiotoxicity. Conclusions: Though there are some studies that suggest that Tei index may be a useful indicator in assessing subclinical anthracycline-related cardiotoxicity, the findings are inconsistent and so more studies are needed before the evaluation of Tei index is performed routinely in patients receiving chemotherapy.
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spelling doaj.art-167e8185501246a785fd8a3b45d55a672022-12-22T02:56:41ZengBMCEcho Research and Practice2055-04642055-04642021-05-0181R1R11https://doi.org/10.1530/ERP-20-0013The role of the Tei index in assessing for cardiotoxicity from anthracycline chemotherapy: a systematic reviewSadie Bennett0Arzu Cubukcu1Chun Wai Wong2Timothy Griffith3Cheryl Oxley4Diane Barker5Simon Duckett6Duwarakan Satchithananda7Ashish Patwala8Grant Heatlie9Chun Shing Kwok10Royal Stoke University Hospital, Stoke-on-Trent, UKRoyal Stoke University Hospital, Stoke-on-Trent, UK; Macclesfield District General Hospital, Macclesfield, UKRoyal Stoke University Hospital, Stoke-on-Trent, UK; Primary Care & Health Sciences, Keele University, Stoke-on-Trent, UKRoyal Stoke University Hospital, Stoke-on-Trent, UKRoyal Stoke University Hospital, Stoke-on-Trent, UKRoyal Stoke University Hospital, Stoke-on-Trent, UKRoyal Stoke University Hospital, Stoke-on-Trent, UKRoyal Stoke University Hospital, Stoke-on-Trent, UKRoyal Stoke University Hospital, Stoke-on-Trent, UKRoyal Stoke University Hospital, Stoke-on-Trent, UKRoyal Stoke University Hospital, Stoke-on-Trent, UK; Primary Care & Health Sciences, Keele University, Stoke-on-Trent, UKBackground: Anthracycline agents are known to be effective in treating tumors and hematological malignancies. Although these agents improve survival, their use is associated with cardiotoxic effects, which most commonly manifests as left ventricular systolic dysfunction (LVSD). As such, guidelines recommend the periodic assessment of left ventricular ejection fraction (LVEF). However, as diastolic dysfunction likely proceeds systolic impairment in this setting, the role of Tei index may offer additional benefit in detecting subclinical LVSD. Methods: We conducted a systematic review to investigate the evidence for the use of Tei index in assessing subclinical cardiotoxicity in patients receiving anticancer agents. A search of Medline and EMBASE was performed and relevant studies were reviewed and narratively synthesized. Results: A total of 13 studies were included with a total of 800 patients (mean age range 46–62 years, percentage of male participants ranged from 0–86.9%). An increase in Tei index was observed in 11 studies, which suggested a decline in cardiac function following chemotherapy. Out of these, six studies indicated that the Tei index is a useful parameter in predicting cardiotoxic LVSD. Furthermore, five studies indicated Tei index to be superior to LVEF in detecting subclinical cardiotoxicity. Conclusions: Though there are some studies that suggest that Tei index may be a useful indicator in assessing subclinical anthracycline-related cardiotoxicity, the findings are inconsistent and so more studies are needed before the evaluation of Tei index is performed routinely in patients receiving chemotherapy.https://erp.bioscientifica.com/view/journals/echo/8/1/ERP-20-0013.xmlmyocardial performance indextei indexcardiotoxicity2d echocardiography
spellingShingle Sadie Bennett
Arzu Cubukcu
Chun Wai Wong
Timothy Griffith
Cheryl Oxley
Diane Barker
Simon Duckett
Duwarakan Satchithananda
Ashish Patwala
Grant Heatlie
Chun Shing Kwok
The role of the Tei index in assessing for cardiotoxicity from anthracycline chemotherapy: a systematic review
Echo Research and Practice
myocardial performance index
tei index
cardiotoxicity
2d echocardiography
title The role of the Tei index in assessing for cardiotoxicity from anthracycline chemotherapy: a systematic review
title_full The role of the Tei index in assessing for cardiotoxicity from anthracycline chemotherapy: a systematic review
title_fullStr The role of the Tei index in assessing for cardiotoxicity from anthracycline chemotherapy: a systematic review
title_full_unstemmed The role of the Tei index in assessing for cardiotoxicity from anthracycline chemotherapy: a systematic review
title_short The role of the Tei index in assessing for cardiotoxicity from anthracycline chemotherapy: a systematic review
title_sort role of the tei index in assessing for cardiotoxicity from anthracycline chemotherapy a systematic review
topic myocardial performance index
tei index
cardiotoxicity
2d echocardiography
url https://erp.bioscientifica.com/view/journals/echo/8/1/ERP-20-0013.xml
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