Benefit of combining quantitative cardiac CT parameters with troponin I for predicting right ventricular dysfunction and adverse clinical events in patients with acute pulmonary embolism

• Verfasst von: Meyer, Mathias [VerfasserIn]
• Verfasst von: Fink, Christian [VerfasserIn]
• Verfasst von: Röger, Susanne [VerfasserIn]
• Verfasst von: Apfaltrer, Paul [VerfasserIn]
• Verfasst von: Haghi, Dariusch [VerfasserIn]
• Verfasst von: Kaminski, Wolfgang E. [VerfasserIn]
• Verfasst von: Neumaier, Michael [VerfasserIn]
• Verfasst von: Schönberg, Stefan [VerfasserIn]
• Verfasst von: Henzler, Thomas [VerfasserIn]
• Titel: Benefit of combining quantitative cardiac CT parameters with troponin I for predicting right ventricular dysfunction and adverse clinical events in patients with acute pulmonary embolism
• Verf.angabe: Mathias Meyer, Christian Fink, Susanne Roeger, Paul Apfaltrer, Dariush Haghi, Wolfgang E. Kaminski, Michael Neumaier, Stefan O. Schoenberg, Thomas Henzler
• E-Jahr: 2012
• Jahr: November 2012
• Umfang: 6 S.
• Fussnoten: Gesehen am 20.11.2018
• Titel Quelle: Enthalten in: European journal of radiology
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1990
• Jahr Quelle: 2012
• Band/Heft Quelle: 81(2012), 11, Seite 3294-3299
• ISSN Quelle: 1872-7727
• DOI: doi:10.1016/j.ejrad.2012.06.023
• Datenträger: Online-Ressource
• Sprache: eng
• Bibliogr. Hinweis: Erscheint auch als : Druck-Ausgabe: Benefit of combining quantitative cardiac CT parameters with troponin I for predicting right ventricular dysfunction and adverse clinical events in patients with acute pulmonary embolism. - 2012
• Sach-SW: Adverse outcome
• Sach-SW: Computed tomography
• Sach-SW: Pulmonary embolism
• Sach-SW: Right ventricular dysfunction
• Sach-SW: Troponin I
• K10plus-PPN: 1584611421

Abstract

Objective To prospectively evaluate the diagnostic accuracy of quantitative cardiac CT parameters alone and in combination with troponin I for the assessment of right ventricular dysfunction (RVD) and adverse clinical events in patients with acute pulmonary embolism (PE). Materials and results: This prospective study had institutional review board approval and was HIPAA compliant. In total 83 patients with confirmed PE underwent echocardiography and troponin I serum level measurements within 24h. Three established cardiac CT measurements for the assessment of RVD were obtained (RV/LVaxial, RV/LV4-CH, and RV/LVvolume). CT measurements and troponin I serum levels were correlated with RVD found on echocardiography and adverse clinical events according to Management Strategies and Prognosis in Pulmonary Embolism Trial-3 (MAPPET-3 criteria. 31 of 83 patients with PE had RVD on echocardiography and 39 of 83 patients had adverse clinical events. A RV/LVvolume ratio>1.43 showed the highest area under the curve (AUC) (0.65) for the prediction of adverse clinical events when compared to RV/LVaxial, RV/LV4Ch and troponin I. The AUC for the detection of RVD of RV/LVaxial, RV/LV4Ch, RV/LVvolume, and troponin I were 0.86, 0.86, 0.92, and 0.69, respectively. Combination of RV/LVaxial, RV/LV4Ch, RV/LVvolume with troponin I increased the AUC to 0.87, 0.87 and 0.93, respectively. Conclusion: A combination of cardiac CT parameters and troponin I measurements improves the diagnostic accuracy for detecting RVD and predicting adverse clinical events if compared to either test alone.