title: Relationship between cardiac troponin-T and right ventricular Tei index in patients with hemodynamically stable pulmonary embolism: an observational study.
abstract: OBJECTIVE
  The role of increased troponin level in risk stratification of acute pulmonary embolism (PE) is well documented. However, relation between right ventricular (RV) myocardial performance (Tei) index and cardiac troponin-T (cTn-T) has not been well investigated. The purpose of this observational prospective study was to assess the relationship between the RV Tei index and cTn-T in patients with acute normotensive PE.
  
  
  METHODS
  Thirty-eight patients with acute PE diagnosed by computed spiral tomography pulmonary angiography were enrolled to this prospective observational study. All study population underwent a comprehensive echocardiographic study including tissue Doppler imaging within first 12 hours of admission. cTn-T levels were measured on admission. Follow-up echocardiography was performed routinely at the 7th day of hospitalization. Echocardiographic evaluation was repeated at 90 days in patients with insufficient improvement of RV Tei index. The difference between the baseline and follow-up data was analyzed using the paired sample t-test or Wilcoxon test according to normality of distribution.
  
  
  RESULTS
  The mean of the RV Tei index was 0.46 ± 0.14 and the mean systolic pulmonary artery pressure (sPAP) was 40 ± 20 mmHg. Increased cTn-T level was detected in 37% of the patients (normal value 0.01< ng/mL). Significant correlations were observed between RV Tei index and sPAP with cTn-T levels (r=0.467 and r=0.468, p<0.001, respectively). In logistic regression analysis, RV Tei index was associated with positive cTn-T values (OR-136, 95% CI: 1.3-14657, p=0.039). After the anticoagulant treatment, RV Tei index and sPAP were significantly improved.
  
  
  CONCLUSIONS
  RV Tei index is frequently impaired in patients with acute PE and a significant recovery is seen after the treatment. Therefore, RV Tei index may be used both the diagnosis of RV dysfunction and the assessment of treatment effectiveness. RV Tei index is may predict myocardial injury in PE.
authors.affiliation: Department of Chest Diseases, Faculty of Medicine, Karadeniz Teknik University, Trabzon-Turkey.
authors.forename: Savaş
authors.initials: S
authors.lastname: Özsu
authors.forename: Abdülkadir
authors.initials: A
authors.lastname: Kırış
authors.forename: Yılmaz
authors.initials: Y
authors.lastname: Bülbül
authors.forename: Funda
authors.initials: F
authors.lastname: Öztuna
authors.forename: Kayıhan
authors.initials: K
authors.lastname: Karaman
authors.forename: Merih
authors.initials: M
authors.lastname: Kutlu
authors.forename: Tevfik
authors.initials: T
authors.lastname: Özlü
mesh_terms: D015150:Echocardiography, Doppler; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000097:blood / Q000503:physiopathology*; D012044:Regression Analysis; D020107:Troponin T / Q000097:blood*; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000503:physiopathology*
chemical_list: D020107:Troponin T