Correlation between cardiac biomarkers and right ventricular enlargement on chest CT in non massive pulmonary embolism.
BACKGROUND
Troponin I (cTnI), myoglobin, heart-type fatty acid binding protein (H-FABP), and natriuretic peptides (BNP, NTproBNP) were all reported to be elevated in patients with pulmonary embolism (PE).


METHODS
To assess the correlation between the aforementioned markers and helical computed tomography (hCT) right ventricular dysfunction (RVD) in non massive PE, we performed this prospective pilot study on 50 patients.


RESULTS
Patients with RVD had significant higher natriuretic peptides prevalence than cardiomyocytes damage-related markers (48% vs 20%, P=0.006). Significant prevalence differences were observed only for natriuretic peptides when patients with RVD and those without were compared (74% vs 33% for NT-pro BNP, P=0.005 and 65% vs 22% for BNP, P=0.003). Patients with RVD had significant higher biomarkers median plasmatic values than those without (BNP: 170 vs 36 pg/ml, P=0.0027; NT-proBNP: 1369 vs 170.7 pg/ml, P=0.0024; cTnI: 0.032 vs 0 ng/ml, P=0.0034; H-FABP: 4.32 vs 2.23 ng/ml, P=0.0032; myoglobin: 36.7 vs 28.2 ng/ml, P=0.03). Significant correlations were only obtained between RV/LV index and plasmatic natriuretic peptides (NT-proBNP: r=0.36, P=0.009; BNP r=0.28; P=0.047).


CONCLUSIONS
Natriuretic peptides prevalence elevation and median values are significantly higher when RVD is present and significantly correlate with hCT RVD.
Vuilleumier
Nicolas
N
Department of Pathology, Clinical Chemistry, Geneva University Hospital, Switzerland. nicolas.vuilleumier@hcuge.ch
Righini
Marc
M
Perrier
Arnaud
A
Rosset
Antoine
A
Turck
Natacha
N
Sanchez
Jean-Charles
JC
Bounameaux
Henri
H
Le Gal
Grégoire
G
Mensi
Noury
N
Hochstrasser
Denis
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D005260:Female; D006801:Humans; D017380:Hypertrophy, Right Ventricular / Q000097:blood / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009211:Myoglobin / Q000097:blood; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000097:blood / Q000000981:diagnostic imaging*; D012372:ROC Curve; D013902:Radiography, Thoracic; D036542:Tomography, Spiral Computed; D019210:Troponin I / Q000097:blood
D015415:Biomarkers; D009211:Myoglobin; D010446:Peptide Fragments; D019210:Troponin I; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain