High-sensitivity troponin and right ventricular function in acute pulmonary embolism.

Gustavo Daquarti, Nicolás March Vecchio, Cecilia Soledad Mitrione,Juan Furmento, María Clara Ametrano, María Paz Dominguez Pace,Juan Pablo Costabel

The American Journal of Emergency Medicine(2016)

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摘要
Introduction: Right ventricular (RV) dysfunction has proved to be an important predictor of morbidity and mortality in patients with pulmonary embolism(PE). Tricuspid annular plane systolic excursion (TAPSE) is one of the parameters that have been validated as predictor of outcomes. The aim of our study was to evaluate the performance (sensitivity and specificity) of high-sensitivity cardiac troponin T (hs-cTnT) to predict RV dysfunction defined as TAPSE < 16 mm. Methods: We conducted a single-center retrospective analysis of 40 patients prospectively included. Median age was 66 years (59-76) and PESI score was 81 (67-100). Results: Right ventricular dysfunction was present in 30% of the patients and was associated with higher median troponin values (33.5 ng/L vs 16 ng/L; P=.03). A logarithmic relation was observed between hs-cTnT and lower TAPSE values (r(2)=0.36; P<.0001). The area under the ROC curve of hs-cTnT to predict RV dysfunction was 0.77 (0.63-0.92). Conclusion: hs-cTnT is a biomarker with good performance to identify RV dysfunction in PE. (C) 2016 Elsevier Inc. All rights reserved.
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