title: Cardiac troponin I elevation in acute pulmonary embolism is associated with right ventricular dysfunction.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Cardiology, University of Göttingen, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Meyer
authors.forename: L
authors.initials: L
authors.lastname: Binder
authors.forename: N
authors.initials: N
authors.lastname: Hruska
authors.forename: H
authors.initials: H
authors.lastname: Luthe
authors.forename: A B
authors.initials: AB
authors.lastname: Buchwald
mesh_terms: D000208:Acute Disease; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000097:blood* / Q000150:complications*; D019210:Troponin I / Q000097:blood*; D018497:Ventricular Dysfunction, Right / Q000097:blood* / Q000209:etiology*
chemical_list: D019210:Troponin I