Key result
RV Tei index linked to ~136-fold higher odds of positive troponin-T in acute normotensive PE.
Why the study?
The relationship between right ventricular myocardial performance (Tei) index and cardiac troponin-T in patients with acute normotensive pulmonary embolism has not been well investigated.
Is the right ventricular Tei index associated with cardiac troponin-T levels in patients with acute normotensive pulmonary embolism?
Observational (n=38)
Is the right ventricular Tei index associated with cardiac troponin-T levels in patients with acute normotensive pulmonary embolism?
In patients with acute normotensive pulmonary embolism, the RV Tei index correlates significantly with cardiac troponin-T levels and improves following anticoagulant treatment, suggesting its utility in predicting myocardial injury and assessing treatment response.
RV Tei index was associated with cTn-T elevation in normotensive PE; leaves open incremental value for risk stratification beyond biomarkers.
OBJECTIVE: The role of increased troponin level in risk stratification of acute pulmonary embolism (PE) is well documented. However, relation between right ventricular (RV) myocardial performance (Tei) index and cardiac troponin-T (cTn-T) has not been well investigated. The purpose of this observational prospective study was to assess the relationship between the RV Tei index and cTn-T in patients with acute normotensive PE. METHODS: Thirty-eight patients with acute PE diagnosed by computed spiral tomography pulmonary angiography were enrolled to this prospective observational study. All study population underwent a comprehensive echocardiographic study including tissue Doppler imaging within first 12 hours of admission. cTn-T levels were measured on admission. Follow-up echocardiography was performed routinely at the 7th day of hospitalization. Echocardiographic evaluation was repeated at 90 days in patients with insufficient improvement of RV Tei index. The difference between the baseline and follow-up data was analyzed using the paired sample t-test or Wilcoxon test according to normality of distribution. RESULTS: The mean of the RV Tei index was 0.46 ± 0.14 and the mean systolic pulmonary artery pressure (sPAP) was 40 ± 20 mmHg. Increased cTn-T level was detected in 37% of the patients (normal value 0.01< ng/mL). Significant correlations were observed between RV Tei index and sPAP with cTn-T levels (r=0.467 and r=0.468, p<0.001, respectively). In logistic regression analysis, RV Tei index was associated with positive cTn-T values (OR-136, 95% CI: 1.3-14657, p=0.039). After the anticoagulant treatment, RV Tei index and sPAP were significantly improved. CONCLUSION: RV Tei index is frequently impaired in patients with acute PE and a significant recovery is seen after the treatment. Therefore, RV Tei index may be used both the diagnosis of RV dysfunction and the assessment of treatment effectiveness. RV Tei index is may predict myocardial injury in PE.
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Özsu et al. (2012) conducted an observational in Acute normotensive pulmonary embolism (n=38). Right ventricular Tei index was evaluated on Positive cardiac troponin-T values (OR 136, 95% CI 1.3-14657, p=0.039). The right ventricular Tei index was significantly associated with positive cardiac troponin-T values in patients with acute normotensive pulmonary embolism (OR 136; 95% CI 1.3-14657; p=0.039).
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