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, 36 (5), 1632-6

Cardiac Troponin I Elevation in Acute Pulmonary Embolism Is Associated With Right Ventricular Dysfunction

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Cardiac Troponin I Elevation in Acute Pulmonary Embolism Is Associated With Right Ventricular Dysfunction

T Meyer et al. J Am Coll Cardiol.

Abstract

Objectives: The purpose of this study was to evaluate the prevalence and diagnostic utility of cardiac troponin I to identify patients with right ventricular (RV) dysfunction in pulmonary embolism.

Background: Right ventricular overload resulting from elevated pulmonary resistance is a common finding in major pulmonary embolism. However, biochemical markers to assess the degree of RV dysfunction have not been evaluated so far.

Methods: In this prospective, double-blind study we included 36 study patients diagnosed as having acute pulmonary embolism.

Results: Among the whole study population, 14 patients (39%) had positive troponin I tests. Ten of 16 patients (62.5%) with RV dilatation had increased serum troponin I levels, while only 4 of 14 patients (28.6%) with elevated troponin I values had a normal RV diameter as assessed by echocardiography, indicating that positive troponin I tests were significantly associated with RV dilatation (p = 0.009). Patients with positive troponin I tests had significantly more segmental defects in ventilation/perfusion lung scans than patients with normal serum troponin I (p = 0.0002).

Conclusions: Our data demonstrate that more than one-third of patients clinically diagnosed as having pulmonary embolism presented with elevated serum troponin I concentrations. Troponin I tests helped to identify patients with RV dilatation who had significantly more segmental defects in lung scans. Thus, troponin I assays are useful to detect minor myocardial damage in pulmonary embolism.

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