Cardiac troponin I elevation in acute pulmonary embolism is associated with right ventricular dysfunction

J Am Coll Cardiol. 2000 Nov 1;36(5):1632-6. doi: 10.1016/s0735-1097(00)00905-0.


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.

MeSH terms

  • Acute Disease
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Pulmonary Embolism / blood*
  • Pulmonary Embolism / complications*
  • Troponin I / blood*
  • Ventricular Dysfunction, Right / blood*
  • Ventricular Dysfunction, Right / etiology*


  • Troponin I