American Heart Journal
Volume 145, Issue 5 , Pages 821-825 , May 2003

Clinical usefulness and prognostic value of elevated cardiac troponin I levels in acute pulmonary embolism

  • Nirav J Mehta, MD

      Affiliations

    • Division of Cardiology, Creighton University School of Medicine, Omaha, Neb, USA
    • ,
  • Ketan Jani, MD

      Affiliations

    • Long Island College Hospital, Brooklyn, NY, USA
    • ,
  • Ijaz A Khan, MD, FACP, FACC

      Affiliations

    • Division of Cardiology, Creighton University School of Medicine, Omaha, Neb, USA
    • Corresponding Author InformationReprint requests: Ijaz A. Khan, MD, FACP, FACC, Creighton University Cardiac Center, 3006 Webster St, Omaha, NE, USA 68131-2044.

,Accepted 3 June 2002.

References 

  1. Goldhaber SZ, Haire WD, Feldstein ML, et al.  Alteplase plus heparin in acute pulmonary embolism (randomized trail assessing right ventricular function and pulmonary perfusion). Lancet. 1993;341:507–511
  2. Kasper W, Konstantinides S, Geibel A, et al.  Prognostic significance of right ventricular afterload stress detected by echocardiography in patients with clinically suspected pulmonary embolism. Heart. 1997;77:346–349
  3. Konstantinides S, Geibel A, Olschewski M, et al.  Association between thrombolytic treatment and the prognosis of hemodynamically stable patients with major pulmonary embolism. Circulation. 1997;96:882–888
  4. Wolfe MW, Lee RT, Feldstein ML, et al.  Prognostic significace of right ventricular hypokinesis and perfusion lung scan defects in pulmonary embolism. Am Heart J. 1994;127:1371–1375
  5. Goldhaber SZ, Visani L, De Rosa M. Acute pulmonary embolism (clinical outcomes in the International Cooperative Pulmonary Embolism Registry). Lancet. 1993;353:1386–1389
  6. Kasper W, Meinertz T, Henkel B, et al.  Echocardiographic findings in patients with proved pulmonary embolism. Am Heart J. 1986;112:1284–1290
  7. Belenkie I, Dani R, Smith ER, et al.  Ventricular interaction during experimental acute pulmonary embolism. Circulation. 1988;78:761–768
  8. Hamm CW, Goldmann BU, Heeschen C, et al.  Emergency room triage of patients with acute chest pain by means of rapid testing for cardiac troponin T or troponin I. N Eng J Med. 1997;337:1648–1653
  9. Morrow DA, Rifai N, Tanasijevic MJ, et al.  Clinical efficacy of three assays for cardiac troponin I for risk stratification in acute coronary syndromes (a Thrombolysis in Myocardial Infarction (TIMI) 11 B substudy). Clin Chem. 2000;46:453–460
  10. Antman EM, Tanasijevic MJ, Thompson B, et al.  Cardiac-specific troponin I levels to predict the risk of mortality in patients with acute coronary syndromes. N Eng J Med. 1996;335:1342–1349
  11. Adams JE, Bodor GS, Davilla-Roman VG, et al.  Cardiac troponin I (a marker with high specificity for cardiac injury). Circulation. 1993;88:101–106
  12. Bodor GS, Porterfield D, Voss EM, et al.  Cardiac troponin I is not expressed in fetal and healthy or diseased adult human skeletal muscle tissue. Clin Chem. 1995;41:1710–1715
  13. Horn H, Dack S, Friedberg CK. Cardiac sequele of embolism of the pulmonary artery. Arch Intern Med. 1939;64:296–321
  14. Gold FL, Bache RJ. Transmural right ventricular blood flow during acute pulmonary artery hypertension in the sedated dog. Evidence of subendocardial ischemia despite residual vasodilator reserve. Circ Res. 1982;51:196–204
  15. Vlahkes GJ, Turley K, Hoffman JIE. The pathophysiology of failure in acute right ventricular hypertension (hemodynamic and biochemical correlations). Circulation. 1981;63:87–95
  16. Brooks H, Kirk ES, Vokonas PS, et al.  Performance of the right ventricle under stress (relation to right coronary flow). J Clin Invest. 1971;50:2176–2183
  17. Coma-Canella I, Gamello C, Martinez-Onsurbe P, et al.  Acute right ventricular infarction secondary to massive pulmonary embolism. Eur Heart J. 1988;9:534–540
  18. Adams JE, Siegel BA, Goldstein JA, et al.  Elevations of CK-MB following pulmonary embolism. Chest. 1992;101:1203–1206
  19. Giannitsis E, Bardorff-Muller M, Kurowski V, et al.  Independent prognostic value of cardiac troponin T in patients with confirmed pulmonary embolism. Circulation. 2000;102:211–217
  20. Meyer T, Binder L, Hruska N, et al.  Cardiac troponin I elevation in acute pulmonary embolism is associated with right ventricular dysfunction. J Am Coll Cardiol. 2000;36:1632–1636
  21. Douketis JD, Growther MA, Stanton EB, et al.  Elevated cardiac troponin levels in patients with submassive pulmonary embolism. Arch Intern Med. 2002;162:79–81
  22. Goldhaber SZ. Echocardiography in the management of pulmonary embolism. Ann Intern Med. 2002;136:691–700

PII: S0002-8703(02)94704-6

doi: 10.1016/S0002-8703(02)94704-6

American Heart Journal
Volume 145, Issue 5 , Pages 821-825 , May 2003

Article Tools

* Image Usage & Resolution