Abstract 14722: The Utility of Tei Index in Subclinical Cardiotoxicity After Chemotherapy

Abstract

Introduction: It was reported left ventricular global longitudinal strain (LVGLS) was useful to diagnose subclinical cardiotoxicity (SC) after chemotherapy. Doppler Tei index has been known as a noninvasive and useful indicator of systolic and diastolic myocardial performance. Until now, it has not been reported about the utility of Tei index in SC after anthracycline-based chemotherapy. Methods: We retrospectively enrolled patients with malignant lymphoma or acute myeloid leukemia receiving anthracycline-based chemotherapy from 2010 to 2019. Thirty patients were performed echocardiographic examination before and after chemotherapy. We measured LV parameters (LVGLS, LV end-diastolic diameter, LV end-systolic diameter, LV ejection fraction, LV-Tei index), and RV parameters (RV fractional area change, RV-Tei index). Patients were divided into SC and non-SC groups according to a relative percentage reduction in LVGLS of greater than 15% to baselines. Then, we compared LV and RV parameters between groups, and explored which parameters were related to SC. Results: Five patients (16%) were divided into SC group with decreased %ΔGLS (22.5±6.7%). LV end-diastolic diameter, LV end-systolic diameter, and RV fractional area change were slightly higher in non-SC although still no significance. ΔLV-Tei index and ΔRV-Tei index were significantly greater In SC group compared to non-SC group (0.22±0.10 versus 0.15±0.03, p=0.032. 0.18±0.08 versus 0.14±0.02, p=0.014, respectively). ΔLV-Tei index and ΔRV-Tei index significantly correlated with ΔGLS (r=0.46, p=0.009. r=0.39, p=0.03). Receiver-operating characteristic curve analysis identified the optimal ΔLV-Tei index and ΔRV-Tei cutoff for predicting SC as 0.09 and 0.05 (area under the curve of 0.81, p=0.029. 0.86, p=0.028). Conclusions: LV and RV-Tei index was affected by chemotherapy. Our study suggests that Tei index can be a useful indicator for SC after anthracycline-based chemotherapy.