ANP, BNP and D-dimer predict right ventricular dysfunction in patients with acute pulmonary embolism.
BACKGROUND
The aim of this study was to predict right ventricular dysfunction (RVD) using plasma concentration of D-dimer, pro-atrial natriuretic peptide (pro-ANP), brain natriuretic peptide (BNP), endothelin-1 (ET-1) and cardiac troponin I (TNI) in patients with pulmonary embolism (PE).


METHODS
Patients suspected of PE had a ventilation/perfusion-single-photon emission-tomography (V/Q-SPECT), pulmonary multidetector computer tomography (MDCT) angiography, blood samples and ECG-gated cardiac CT performed the same day.


RESULTS
Pro-ANP, BNP and D-dimer are associated with significantly elevated levels in PE patients with RVD. ROC curves demonstrated that D-dimer, pro-ANP and BNP were accurate for detection of RVD.


CONCLUSIONS
Because measurements of cardiac biomarkers are inexpensive and easily obtained they may prove useful in the clinical diagnosis of RVD. However because of the small sample size, the results need to be confirmed in larger studies.
Gutte
Henrik
H
Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Mortensen
Jann
J
Jensen
Claus V
CV
von der Recke
Peter
P
Petersen
Claus L
CL
Kristoffersen
Ulrik S
US
Kjaer
Andreas
A
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D009320:Atrial Natriuretic Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D003718:Denmark; D019332:Endothelin-1 / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D016017:Odds Ratio; D055420:Perfusion Imaging; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D012372:ROC Curve; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D019210:Troponin I / Q000097:blood; D015854:Up-Regulation; D018497:Ventricular Dysfunction, Right / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D016278:Ventricular Function, Right
D015415:Biomarkers; D019332:Endothelin-1; D005338:Fibrin Fibrinogen Degradation Products; D019210:Troponin I; C036309:fibrin fragment D; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor