Role of Cardiac Biomarkers and Tomographic Right Ventricular Dysfunction Findings in the Treatment of Pulmonary Thromboembolism

Abstract

Aim

Deaths from acute pulmonary thromboembolism are caused by right ventricular dysfunction (RVD) and often occur within the first hour. Diagnostic computed tomography-pulmonary angiography (CTPA) is a useful tool for the early and rapid evaluation of RVD. We aimed to evaluate the effect of RVD findings on risk classification and treatment.

Materials and Methods

This retrospective study included patients who applied to the emergency department on specified dates and were diagnosed with pulmonary thromboembolism. The right ventricle (RV) and left ventricle (LV) diameters (mm), ratio of these diameters RV/LV, pulmonary artery and aortic diameter (mm), troponin, and BNP were evaluated.

Results

A total of 119 patients were studied. The average age of the participants was 63.3 years. The mortality rate was 12.6%. Reperfusion therapy was applied to 25 (21%) patients. RV/LV was superior for predicting thrombolytic therapy. N-terminal proBNP (NT-proBNP) was more significant than troponin. When both parameters were evaluated together, the result was superior in predicting reperfusion therapy in patients with RVD.

Conclusion

CTPA can be used safely to determine the risk group and for treatment with its high sensitivity. NT-proBNP is an important biomarker for determining thrombolytic treatment, and its diagnostic specificity increases when evaluated together with RV/LV.