High-sensitivity troponin and right ventricular function in acute pulmonary embolism

Area of Science:

• Cardiology
• Pulmonary Medicine
• Biomarker Research

Background:

• Right ventricular (RV) dysfunction is a critical predictor of morbidity and mortality in pulmonary embolism (PE).
• Tricuspid annular plane systolic excursion (TAPSE) is a validated parameter for predicting outcomes in PE.
• Assessing RV dysfunction is crucial for managing PE patients.

Purpose of the Study:

• To evaluate the performance of high-sensitivity cardiac troponin T (hs-cTnT) in predicting RV dysfunction.
• To determine the sensitivity and specificity of hs-cTnT for identifying RV dysfunction defined as TAPSE <16 mm.

Main Methods:

• A single-center retrospective analysis of 40 prospectively included patients.
• Median age of patients was 66 years with a median PESI score of 81.
• Correlation and ROC curve analysis were used to assess hs-cTnT performance.

Main Results:

• RV dysfunction was present in 30% of patients and associated with higher hs-cTnT levels (33.5 ng/L vs 16 ng/L; P = .03).
• A logarithmic relationship was observed between hs-cTnT and lower TAPSE values (r² = 0.36; P < .0001).
• The area under the ROC curve for hs-cTnT to predict RV dysfunction was 0.77 (95% CI: 0.63-0.92).

Conclusions:

• hs-cTnT demonstrates good performance as a biomarker for identifying RV dysfunction in patients with PE.
• Elevated hs-cTnT levels are significantly associated with RV dysfunction in PE.
• hs-cTnT can aid in the risk stratification of PE patients.