title: [Troponin-I in hemodynamically-stable pulmonary embolism: correlation with echocardiography and computed tomography angiography].
abstract: BACKGROUND
  Troponin-I (TnI) is a marker of severe pulmonary thromboembolism (PTE) in unselected patients. There are few articles that assess its usefulness in hemodynamically-stable patients.
  
  
  OBJECTIVE
  To assess the correlation between TnI levels and both echocardiographic/radiologic signs of right ventricle (RV) dysfunction or pulmonary hypertension (PH), and the severity of the pulmonary vascular obstruction.
  
  
  METHODS
  We selected patients from a prospective cohort of 103 consecutive patients with PTE and systolic arterial pressure ≥ 90 mmHg. Computed tomography pulmonary angiography (CTPA) and echocardiography were performed in all patients. We performed a post hoc study, analyzing the 68 cases in which TnI was measured, at the discretion of the emergency room physician.
  
  
  RESULTS
  Patients included had a median age of 74 years and 50% were male. The patients with elevated TnI had a differentiated clinical profile, suggestive of more severe PTE. There was a significant correlation between TnI levels and systolic pulmonary artery pressure (r=0.46, P<.001), the CTPA-measured pulmonary artery diameter (r=0.48, P<.001), the CTPA-measured RV diameter (r=0.47, P=.001) and the pulmonary vascular obstruction index (r=0.39, P=.001).
  
  
  CONCLUSIONS
  The higher levels of TnI in patients with hemodynamically stable PTE predicts the existence of more severe PE in hemodynamically-stable patients. This biomarker could be used in the clinical practice to select those patients who might require more intensive monitoring or additional complementary studies.
authors.affiliation: Servicio de Neumología, Complexo Hospitalario Xeral-Calde, Lugo, España. rafael.golpe.gomez@sergas.es
authors.forename: R
authors.initials: R
authors.lastname: Golpe
authors.forename: L A
authors.initials: LA
authors.lastname: Pérez-de-Llano
authors.forename: O
authors.initials: O
authors.lastname: Castro-Añón
authors.forename: M
authors.initials: M
authors.lastname: Vázquez-Caruncho
authors.forename: C
authors.initials: C
authors.lastname: González-Juanatey
authors.forename: M C
authors.initials: MC
authors.lastname: Fariñas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D004452:Echocardiography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000097:blood* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D019210:Troponin I / Q000097:blood*
chemical_list: D019210:Troponin I