Elevated cardiac troponin I in acute pulmonary embolism was significantly associated with right ventricular dilatation (P=0.009) and more segmental defects in lung scans (P=0.0002).
Observational (n=36)
Double-blind
Does cardiac troponin I testing identify right ventricular dysfunction in patients with acute pulmonary embolism?
Elevated cardiac troponin I is present in over a third of acute pulmonary embolism patients and is significantly associated with right ventricular dilatation and larger perfusion defects.
p-value: p=0.009
OBJECTIVES: The purpose of this study was to evaluate the prevalence and diagnostic utility of cardiac troponin I to identify patients with right ventricular (RV) dysfunction in pulmonary embolism. BACKGROUND: Right ventricular overload resulting from elevated pulmonary resistance is a common finding in major pulmonary embolism. However, biochemical markers to assess the degree of RV dysfunction have not been evaluated so far. METHODS: In this prospective, double-blind study we included 36 study patients diagnosed as having acute pulmonary embolism. RESULTS: Among the whole study population, 14 patients (39%) had positive troponin I tests. Ten of 16 patients (62.5%) with RV dilatation had increased serum troponin I levels, while only 4 of 14 patients (28.6%) with elevated troponin I values had a normal RV diameter as assessed by echocardiography, indicating that positive troponin I tests were significantly associated with RV dilatation (p = 0.009). Patients with positive troponin I tests had significantly more segmental defects in ventilation/perfusion lung scans than patients with normal serum troponin I (p = 0.0002). CONCLUSIONS: Our data demonstrate that more than one-third of patients clinically diagnosed as having pulmonary embolism presented with elevated serum troponin I concentrations. Troponin I tests helped to identify patients with RV dilatation who had significantly more segmental defects in lung scans. Thus, troponin I assays are useful to detect minor myocardial damage in pulmonary embolism.
Meyer et al. (Wed,) conducted a observational in Acute pulmonary embolism (n=36). Cardiac troponin I testing vs. Normal troponin I was evaluated on Right ventricular dilatation assessed by echocardiography (p=0.009). Elevated cardiac troponin I in acute pulmonary embolism was significantly associated with right ventricular dilatation (P=0.009) and more segmental defects in lung scans (P=0.0002).