Bennett Sadie, Cubukcu Arzu, Wong Chun Wai, Griffith Timothy, Oxley Cheryl, Barker Diane, Duckett Simon, Satchithananda Duwarakan, Patwala Ashish, Heatlie Grant, Kwok Chun Shing
Royal Stoke University Hospital, Stoke-on-Trent, UK.
Macclesfield District General Hospital, Macclesfield, UK.
Echo Res Pract. 2021 May 7;8(1):R1-R11. doi: 10.1530/ERP-20-0013.
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.
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.
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.
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.
已知蒽环类药物在治疗肿瘤和血液系统恶性肿瘤方面有效。尽管这些药物可提高生存率，但使用它们会带来心脏毒性作用，最常见的表现为左心室收缩功能障碍（LVSD）。因此，指南建议定期评估左心室射血分数（LVEF）。然而，由于在这种情况下舒张功能障碍可能先于收缩功能损害出现，Tei指数的作用可能在检测亚临床LVSD方面提供额外的益处。
我们进行了一项系统评价，以调查使用Tei指数评估接受抗癌药物治疗患者亚临床心脏毒性的证据。检索了Medline和EMBASE，并对相关研究进行了综述和叙述性综合分析。
共纳入13项研究，总计800例患者（平均年龄范围46 - 62岁，男性参与者百分比范围为0 - 86.9%）。11项研究观察到Tei指数升高，这表明化疗后心脏功能下降。其中，6项研究表明Tei指数是预测心脏毒性LVSD的有用参数。此外，5项研究表明Tei指数在检测亚临床心脏毒性方面优于LVEF。
尽管有一些研究表明Tei指数可能是评估亚临床蒽环类药物相关心脏毒性的有用指标，但研究结果并不一致，因此在对接受化疗的患者常规进行Tei指数评估之前，还需要更多的研究。
