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

Am J Emerg Med. 2016 Aug;34(8):1579-82. doi: 10.1016/j.ajem.2016.05.071. Epub 2016 May 29.

Abstract

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.

MeSH terms

  • Acute Disease
  • Aged
  • Biomarkers / blood
  • Echocardiography
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Embolism / blood*
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / physiopathology
  • ROC Curve
  • Reproducibility of Results
  • Retrospective Studies
  • Troponin / blood*
  • Ventricular Function, Right / physiology*

Substances

  • Biomarkers
  • Troponin