title: Choice of marker for assessment of RV dysfunction in acute pulmonary embolism : NT-proBNP, pulmonary artery systolic pressure, mean arterial pressure, or blood pressure index.
abstract: BACKGROUND
  We aimed to examine the value of NT-proBNP, pulmonary artery systolic pressure (PASP), blood pressure index (BPI), and mean arterial pressure (MAP) in the determination of right ventricular dysfunction (RVD) in patients with acute pulmonary embolism (APE).
  
  
  METHODS
  A total of 547 patients diagnosed with APE were included in the study. Demographic characteristics and comorbid conditions of patients were recorded in patient files. For blood pressure measurement, a calibrated digital blood pressure monitor was used at regular intervals. Blood samples were taken from patients at the time of admission for hemogram, biochemical, and hemostasis blood tests. Echocardiography was performed on all patients to detect RVD and evaluate pulmonary artery pressure.
  
  
  RESULTS
  PASP (p < 0.001), MAP (p < 0.001), diastolic blood pressure (p < 0.001), D‑dimer (p = 0.001), NT-proBNP (p = 0.001), white blood cell (p < 0.001), and platelet (p = 0.001) counts were higher in APE patients with RVD compared with those without RVD, whereas the mean BPI level (p < 0.001) was lower. BPI had a negative correlation with PASP, NT-proBNP, platelet count, and triglyceride levels in patients with RVD. In regression analysis, BPI and PASP were found to be independent predictors of RVD. In receiver operating characteristic curve analysis, BPI (AUC ± SE = 0.975 ± 0.006; p < 0.001) was found to be the best predictor of RVD with a higher sensitivity (92.8%) and specificity (100%).
  
  
  CONCLUSIONS
  We found that BPI had a better diagnostic discrimination for RVD compared with PASP and NT-proBNP.
authors.affiliation: Department of Chest Disease, Ankara Numune Training and Research Hospital, 06100, Ankara, Turkey. dr.haleates@hotmail.com.
authors.forename: H
authors.initials: H
authors.lastname: Ates
authors.affiliation: Department of Internal Medicine, Ankara Numune Training and Research Hospital, Ankara, Turkey.
authors.forename: I
authors.initials: I
authors.lastname: Ates
authors.affiliation: Department of Cardiology, Ankara Numune Training and Research Hospital, Ankara, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Kundi
authors.affiliation: Department of Biochemistry, Ankara Numune Training and Research Hospital, Ankara, Turkey.
authors.forename: F M
authors.initials: FM
authors.lastname: Yilmaz
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D062186:Arterial Pressure / Q000502:physiology*; D015415:Biomarkers; D000072226:Computed Tomography Angiography; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000503:physiopathology*; D011669:Pulmonary Wedge Pressure / Q000502:physiology; D013599:Systole / Q000502:physiology; D018608:Ultrasonography, Doppler; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis* / Q000503:physiopathology*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Blood pressure; N-terminal pro-BNP; Pulmonary embolisms; Systolic pressure; Ventricular dysfunction