Estimation of the value of echocardiographic Tei index combined with serum high-sensitivity cardiac troponin T assay in early diagnosis of anthracycline-induced cardiotoxicity

Objective To investigate the value of echocardiographic Tei index combined with serum high-sensitivity cardiac troponin T(hs-cTnT) on monitoring cardiac toxicity associated with anthracycline chemotherapy drug in patients with diffuse large B-cell lymphoma(DLBCL). Methods PW-Tei index, TDI-Tei index of left/right ventricles and radionuclide cardiac measurement were acquired from 56 patients with DLBCL before, after the completion of 2-4 cycle(100-200 mg/m2) and 6-8 cycle(300-400 mg/m2) of the regimen, part of them received serum hs-cTnT detection at the same time. Cardiac toxicity event was defined as a relative reduction of radionuclide left ventricular ejection fraction(LVEF) of ≥10% during the regime or an absolute radionuclide LVEF≤50% after the complete chemotherapy. Results Compared with baseline, left ventricular PW-Tei index significantly increased after whole cures[(0.36±0.12) vs (0.44±0.13) vs (0.40±0.13), P=0.002]. After complete regimen, serum hs-cTnT level elevated significantly [(0.006±0.006)μg/L vs (0.012±0.007)μg/L vs (0.020±0.013)μg/L, P=0.001]. The sensitivity, specificity and area under ROC curve of early diagnosis of anthracycline-induced cardiotoxicity with elevated serum hs-cTnT in 2-4 cycle and increased left ventricular PW-Tei index in 6-8cycle detected together were 75%, 85%, 0.736 and 92%, 50%, 0.675, respectively(all P<0.05). Conclusions Echocardiographic PW-Tei index combined with serum hs-cTnT is a simple method and can be easily obtained in outpatient settings to monitor early cardiac toxicity induced by anthracycline therapy. Key words: Echocrdiography; Tei index; Lymphoma, large B-cell, diffuse; High-sensitivity cardiac troponim T; Ventricular function; Anthracyclines