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

https://doi.org/10.1016/S0735-1097(00)00905-0Get rights and content
Under an Elsevier user license
open archive

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.

Abbreviations

CHD
coronary heart disease
CK
creatine kinase
RBBB
right bundle branch block
RV
right ventricular, right ventricle

Cited by (0)