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Evaluation of cardiac biomarkers and right ventricular dysfunction in patients with acute pulmonary embolism [Anatol J Cardiol]
Anatol J Cardiol. 2016; 16(4): 276-282 | DOI: 10.5152/akd.2014.5828  

Evaluation of cardiac biomarkers and right ventricular dysfunction in patients with acute pulmonary embolism

Neşe Dursunoğlu1, Dursun Dursunoğlu2, Ali İhsan Yıldız4, Simin Rota3
1Departments Of Chest, Faculty Of Medicine, Pamukkale University; Denizli- Turkey
2Cardiology, Faculty Of Medicine, Pamukkale University; Denizli- Turkey
3Biochemistry, Faculty Of Medicine, Pamukkale University; Denizli- Turkey
4Ministry Of Health Of The Republic Of Turkey, Servergazi State Hospital; Denizli- Turkey

Objective: Right ventricular dysfunction (RVD) with myocardial damage may lead to fatal complications in patients with acute pulmonary embolism (PE). Cytoplasmic heart-type fatty acid-binding protein (HFABP) and the N-terminal fragment of its prohormone (NT-proBNP) are sensitive and specific biomarkers of myocardial damage. We evaluated RVD and cardiac biomarkers for myocardial damage and short-term mortality in patients with acute PE.
Methods: We analyzed 41 patients (24 females, 17 males) with confirmed acute PE prospective. Three groups (massive, submassive, and nonmassive) of patients were defined, based on systemic systolic blood pressure measured on admission and RVD by transthoracic echocardiography (TTE). Also, systolic (s) and mean (m) pulmonary artery pressures (PAPs) were recorded by TTE, and plasma concentrations of cardiac troponin T (cTn-T), NT-proBNP, and HFABP were evaluated 6 month follow-up.
Results: Seventeen (41.5%) patients experienced a complicated clinical course in the 6-month follow-up for the combined end-point, including at least one of the following: death (n=12, 29.3%; 3 PE-related), chronic PE (n=4, 9.8%), pulmonary hypertension (n=2, 4.9%), and recurrent PE (n=1, 2.4%). Multivariate hazard ratio analysis revealed HFABP, NT-proBNP, and PAPs as the 6-month mortality predictors (HR 1.02, 95% CI 1.01- 1.05; HR 1.01, 95% CI 1.01-1.04; and HR 1.02, 95% CI 1.02-1.05, respectively).
Conclusion: HFABP, NT-proBNP, and PAPs measured on admission may be useful for short-term risk stratification and in the prediction of 6-month PE-related mortality in patients with acute PE. (Anatol J Cardiol 2016; 16: 276-82)

Keywords: pulmonary embolism, right ventricular dysfunction, HFABP, NT-proBNP, cTn-T, mortality


Neşe Dursunoğlu, Dursun Dursunoğlu, Ali İhsan Yıldız, Simin Rota. Evaluation of cardiac biomarkers and right ventricular dysfunction in patients with acute pulmonary embolism. Anatol J Cardiol. 2016; 16(4): 276-282

Corresponding Author: Neşe Dursunoğlu, Türkiye


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