Abstract
Aims
This study prospectively assessed whether Tei index is predictive of early systolic dysfunction in adults undergoing adriamycin treatment.
Methods and results
Left ventricular ejection fraction (LVEF) was obtained by radionuclide ventriculography at baseline and after treatment. Tei index was evaluated by echocardiography at baseline, at an intermediary cycle and at the end of chemotherapy. Fifty-five predominantly female patients (91%) with breast cancer (80%) and without known cardiac disease were evaluated. After treatment (adriamycin dose of 304 ± 47 mg/m2), systolic dysfunction (final LVEF < 50%) occurred in eight patients (14%). Baseline, intermediate or variation of Tei index were not accurate to predict early systolic dysfunction (“c” statistics ≤ 0.60). Baseline Tei index > 0.39, for example, had a sensitivity of 75%, specificity of 55%, positive predictive value of 22% and negative predictive value of 93%.
Conclusion
Tei index does not appear to be a useful tool for detection of early adriamycin cardiotoxicity in adults.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Lipshultz SE, Colan SD, Gelber RD et al (1991) Late cardiac effects of doxorubicin therapy for acute lymphoblastic leukemia in childhood. N Engl J Med 324:808–815
Mitani I, Jain D, Joska TM et al (2003) Doxorubicin cardiotoxicity: Prevention of congestive heart failure with serial cardiac function monitoring with equilibrium radionuclide angiocardiography in the current era. J Nucl Cardiol 10:132–139
Schwartz RG, McKenzie WB (1987) Cardiac heart failure and left ventricular dysfunction complicating doxorubicin therapy. Am J Med 82:1109–1118
Schmitt K, Tulzer G, Merl M et al (1995) Early detection of doxorubicin and daunorubicin cardiotoxicity by echocardiography: diastolic versus systolic parameters. Eur J Pediatr 154:201–204
Galli MA, Conter V, Zanetto F, Jankovic M et al (1987) Cardiotoxicity in children treated with anthracyclines: the role of M-mode echocardiography. Haematologica 72:347–50
Hausdorf G, Morf G, Beron G, Erttmann R et al (1988) Long term doxorubicin cardiotoxicity in childhood: non-invasive evaluation of the contractile state and diastolic filling. Br Heart J 60:309–15
Nousiainen T, Vanninen E, Jantunen E, et al (2001) Comparison of echocardiography and radionuclide ventriculography in the follow-up of left ventricular systolic function in adult lymphoma patients during doxorubicin therapy. J Intern Med 249:297–303
Bonow RO, Bacharach SL, Green MV et al (1981) Impaired left ventricular diastolic filling in patients with coronary artery disease: assessment with radionuclide angiography. Circulation 64:315–323
Bonow RO, Rosing DR, Bacharach SL, et al (1981) Effects of verapamil on left ventricular systolic function and diastolic filling in patients with hypertrophic cardiomyopathy. Circulation 64:787–96
Soufer R, Wohlgelernter D, Vita NA, et al (1985) Intact systolic left ventricular function in clinical congestive heart failure. Am J Cardiol 55:1032–1036
Rabelo E, De Angelis K, Bock P, et al (2001) Baroreflex sensitivity and oxidative stress in adriamycin-induced heart failure. Hypertension 38:576–580
Tei C (1995) New non-invasive index for combined systolic and diastolic ventricular function. Am J Cardiol 26:135–136
Bruch C, Schmermund A, Marin D, et al (2000) Tei-index in patients with mild-to-moderate congestive heart failure. Eur Heart J 21:1888–1895
Harjai KJ, Scott L, Vivekananthan K et al (2002) The Tei index: a new prognostic index for patients with symptomatic heart failure. J Am Soc Echocardiogr 15:864–868
Ishii M, Tsutsumi T, Himeno W, et al (2000) Sequential evaluation of left ventricular myocardial performance in children after anthracycline therapy. Am J Cardiol 86:1279–1281, A9
Schiller NB (1991) Two-dimensional echocardiographic determination of ventricular volume, systolic function, and mass. Summary and discussion of the 1989 recommendations of the American Society of Echocardiography. Circulation 84:1280–1287
Johnson SA (2006). Anthracycline-induced cardiotoxicity in adult hematologic malignancies. Semin Oncol 33(Suppl 8):S22–S27
Keefe DL (2001) Anthracycline-induced cardiomyopathy. Semin Oncol 28:2–7
Cittadini A, Fazio S, D’Ascia C, et al (1991) Subclinical cardiotoxicity by doxorubicin: a pulsed Doppler echocardiographic study. Eur Heart J 12:1000–1005
Stoddard MF, Seeger J, Liddell NE, et al (1992) Prolongation of isovolumetric relaxation time as assessed by Doppler echocardiography predicts doxorubicin-induced systolic dysfunction in humans. J Am Coll Cardiol 20:62–69
Tei C, Ling LH, Hodge DO, et al (1995) New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function—a study in normal and dilated cardiomyopathy. Am J Cardiol 26:357–366
Tei C, Dujardin KS, Hodge DO, et al (1996) Doppler index combining systolic and diastolic myocardial performance: clinical value in cardiac amyloidosis. J Am Coll Cardiol 28:658–664
Ärnlöov J, Ingelsson E, Risérus U, Andrén B, Lind L (2004). Myocardial performance index, a Doppler-derived index of global left ventricular function, predicts congestive heart failure in elderly men. Eur Heart J 25:2220–2225
Belham M, Kruger A, Pritchard C (2006) The Tei index identifies a differential effect on left and right ventricular function with low-dose anthracycline chemotherapy. J Am Soc Echocardiogr 19(2):206–210
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Rohde, L.E., Baldi, A., Weber, C. et al. Tei index in adult patients submitted to adriamycin chemotherapy: failure to predict early systolic dysfunction. Int J Cardiovasc Imaging 23, 185–191 (2007). https://doi.org/10.1007/s10554-006-9145-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10554-006-9145-0