The Diagnostic Values of Brain Natriuretic Peptide and Cardiac Troponin I for Determining the Right Ventricle Dysfunction in Patients with Submassive Pulmonary Thromboembolism

Abstract

Objective: Determining right ventricle dysfunction (RVD) in pulmonary thromboembolism (PTE) is very important for prognosis and treatment options. RVD is usually diagnosed by echocardiographic findings. Recent studies have suggested that the measurement of cardiac troponin I (cTnI), and brain natriuretic peptide (BNP) serum levels can define RVD. The aim of this study is to evaluate the diagnostic value of BNPand cTnI serum levels for determining RVD in patients with submassive PTE. Material and Methods: Fifty patients with a definitive diagnosis of PTE were included into the study. For determining a probable RVD, all patients underwent an echocardiography, and serum levels of BNP, and cTnI were measured during their admission. A control group was created with 19 healthy volunteer whose age was similar to the patients. Results: Right ventricle dysfunction is detected by echocardiography in 52% of patients included into the study. High levels of BNP were found in 73% of patients with RVD (+), and in 12% of patients with RVD (-). When cTnI levels were examined; it was determined that 12% of patients with RVD (+), and 8% of patients with RVD (-) had high cTnI levels. BNP levels were significantly high in patients with RVD (+) when compared with RVD (-), and control groups (p<0.001). When cTnI levels of groups were compared, no significant difference was observed between the three groups. Conclusion: It is suggested that high levels of BNP can be a marker for RVD, patients who have high levels of BNP must be followed closely, and may be assessed for thrombolytic therapy.