Usefulness of cardiac biomarkers in the prediction of right ventricular dysfunction before echocardiography in acute pulmonary embolism.

The aim of this study was to investigate a useful cardiac biomarker for predicting echocardiographic right ventricular (RV) dysfunction in patients with acute pulmonary embolism (APE). A total of 84 patients with APE were divided into two groups: patients with RV dysfunction (group I, n=51, 61.8 ± 15.1 years) versus without RV dysfunction (group II, n=33, 66.8 ± 13.6 years). Cardiac biomarkers were compared between the groups. The level of N-terminal pro-brain-type natriuretic peptide (NT-proBNP), cardiac specific troponin T (cTnt), and I (cTni) was significantly elevated in group I compared to group II, but the level of creatine kinase and high-sensitivity C-reactive protein was not different. By receiver operating characteristic curve analysis, the area under the curve to predict RV dysfunction was 0.912 for NT-proBNP, 0.797 for cTnt, and 0.766 for cTni. The optimal cut-off value to predict RV dysfunction was 620.0 pg/mL for NT-proBNP (sensitivity: 90.2%, specificity: 75.8%), 0.016 ng/mL for cTnt (sensitivity: 82.4%, specificity: 78.8%), and 0.055 ng/mL for cTni (sensitivity: 86.3%, specificity: 66.7%). NT-proBNP > 620 pg/mL and cTnt > 0.016 ng/mL were independent predictors of RV dysfunction on multivariate analysis after adjustment for the baseline characteristics. NT-proBNP, cTnt, and cTni were significant serologic predictors of RV dysfunction in APE. Measurements of NT-proBNP, cTnt, and cTni are simple and useful in the risk stratification or treatment of APE.

Choi HS ，Kim KH ，Yoon HJ ，Hong YJ ，Kim JH ，Ahn Y ，Jeong MH ，Cho JG ，Park JC ，Kang JC ... -  《-》

Right ventricular dysfunction in acute pulmonary embolism: NT-proBNP vs. troponin T.

Dysfunction of the right ventricle (RV) is a parameter of severity in acute pulmonary embolism (PE). Echocardiographic assessment is not always possible in accident and emergency, hence the need to predict the presence of RV dysfunction using easily measurable parameters. To analyse the value of NT-proBNP and troponin T as markers of RV dysfunction in patients with acute PE. Secondarily, to assess the relationship between RV failure and clinical parameters related to PE. Analytical, observational, cross-sectional and retrospective study comparing the values NT-proBNP, troponin T and presenting symptoms of PE among patients with and without RV dysfunction. One hundred seventy-two patients (52 with RV failure,120 without) were included. All symptoms occurred with similar frequency between the 2groups except dyspnea and syncope (more common in the group with RV failure). Both NT-proBNP and troponin T had significantly higher values in the group of patients with RV dysfunction. However, in the multivariate analysis, NT-proBNP had a higher explanatory value for RV failure than troponin T. NT-proBNP is a diagnostic parameter of RV dysfunction with higher sensitivity in the context of acute PE.

Cotugno M ，Orgaz-Molina J ，Rosa-Salazar V ，Guirado-Torrecillas L ，García-Pérez B ... -  《-》

Pulmonary embolism: CT signs and cardiac biomarkers for predicting right ventricular dysfunction.

Henzler T ，Roeger S ，Meyer M ，Schoepf UJ ，Nance JW Jr ，Haghi D ，Kaminski WE ，Neumaier M ，Schoenberg SO ，Fink C ... -  《-》

Biomarker-based risk assessment model in acute pulmonary embolism.

Kostrubiec M ，Pruszczyk P ，Bochowicz A ，Pacho R ，Szulc M ，Kaczynska A ，Styczynski G ，Kuch-Wocial A ，Abramczyk P ，Bartoszewicz Z ，Berent H ，Kuczynska K ... -  《EUROPEAN HEART JOURNAL》

Serum N-terminal brain natriuretic peptide as a prognostic parameter in patients with pulmonary hypertension.

Fijalkowska A ，Kurzyna M ，Torbicki A ，Szewczyk G ，Florczyk M ，Pruszczyk P ，Szturmowicz M ... -  《CHEST》