Effects of Taichi and Cardiac Health, Ejection Fraction among Cancer Patients: A Pilot Study (TICHEFCAP)

Abstract

Background: A particular chemotherapy, such as Adriamycin or Trastuzumab, has been reported to cause worsening cardiac functions. Previous studies showed that Tai chi may enhance some favorable cardiovascular effects with a better quality of life. Nonetheless, there is inadequate evidence to prove Tai chi as a standard of care for cardiac health, and ejection fraction, especially in cancer patients. Objective: To investigate the effects of Tai chi for cardiac health and ejection fraction in cancer patients. Methods: A single-blinded, non-randomized controlled trial was conducted in 30 cancer patients who were sent for echocardiogram before receiving either Adriamycin or Trastuzumab and allocated into either Tai chi or control group. Primary outcomes were LV systolic function and global longitudinal strain (GLS) measured by one blinded cardiologist. Whilst, secondary outcomes included the quality of life measurement by FACT-G score and distress thermometer scale. Results: Data of 18 cancer patients were analyzed (9 patients in each group). For primary outcomes, LV systolic function was increased by 1.44±1.74 % in Tai chi group and decreased by 1.11±4.91 % in control group (p-value = 0.161). When adjusted for confounding factor, the Tai chi group had 4.37% improvement in LV systolic function when compared with the control group (p=0.087). Whereas, GLS was improved by 0.56±1.51 in the Tai chi group and worsened by 0.67±3.46 in the control group (p-value = 0.301). Tai chi also yielded a better quality of life demonstrated by higher post treatment FACT G score (5.25±16.21 in the Tai chi group and 2.56±5.85 in the control group, p-value = 0.647). Nonetheless, distress thermometer scale was lower in the Tai chi group, with the difference of 0.56±2.79 in the tai chi group and -0.11±1.54 in the control group (p-value = 0.538). Conclusion: Tai chi demonstrates favorable outcomes in the improvement of cardiac function (LV systolic function and GLS), with trend of higher quality of life among cancer patients receiving cardiotoxic chemotherapy agents.