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The association of eccentricity indexes with cardiac biomarkers in normotensive acute pulmonary embolism patients: an observational study [Anatol J Cardiol]
Anatol J Cardiol. 2013; 13(2): 108-114 | DOI: 10.5152/akd.2013.033  

The association of eccentricity indexes with cardiac biomarkers in normotensive acute pulmonary embolism patients: an observational study

Mehmet Ali Çetiner1, Muhammet Raşit Sayın2, Nesligül Yıldırım3, Turgut Karabağ2, Mustafa Aydın4
1Zonguldak Karadeniz Ereğli Devlet Hastanesi, Kardiyoloji Kliniği, Zonguldak-Türkiye
2Department of Cardiology, Faculty of Medicine, Bülent Ecevit University, Zonguldak-Turkey
3Department of Cardiology, Faculty of Medicine, Kırıkkale University, Kırıkkale-Turkey
4Zonguldak Karaelmas Üniversitesi Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Zonguldak-Türkiye

 

Objective: The present study aims at investigating the association of systolic and diastolic eccentricity indexes with cardiac biomarkers in hemodynamically stable patients with acute pulmonary embolism (APE).

Methods: Thirty hemodynamically stable (systolic blood pressure >90 mmHg) patients with APE (17M, mean age 61.67±17.6 years) were included in this cross-sectional observational study. The associations of serum troponin I, D-dimer, brain natriuretic peptide (BNP) and heart type fatty acid binding protein (hFABP) levels with systolic and diastolic eccentricity indices, tricuspid annular plane systolic excursion (TAPSE), myocardial performance index (MPI), systolic pulmonary artery pressure and the index of the inferior vena cava were investigated. The relationships between parameters were evaluated by Pearson and Spearman correlation analysis according to the distribution of data.

Results: Correlation analysis revealed that the most significant relationship between cardiac biomarkers and echocardiographic measurements was in the BNP value. Meanwhile, systolic and diastolic eccentricity indexes were found to have significant correlation with serum troponin I (respectively r=0.470, p=0.009/r=0.310, p=0.095) and BNP (respectively r=0.402, p=0.028/r=0.384, p=0.036) values. On the other hand, elevated D-dimer levels led to statistical significance in none of the echocardiographic parameters.

Conclusion: According to our results, hFABP was rarely positive in normotensive patients with APE. An elevated D-dimer alone was not significant in predicting RVD. Eccentricity indexes revealed significant relationship with BNP and troponin I values. The results obtained indicate that early echocardiographic evaluation is important in patients with abnormal cardiac biomarkers. 

Keywords: Acute pulmonary embolism, systolic eccentricity index, diastolic eccentricity index, BNP, troponin I, hFABP


Mehmet Ali Çetiner, Muhammet Raşit Sayın, Nesligül Yıldırım, Turgut Karabağ, Mustafa Aydın. The association of eccentricity indexes with cardiac biomarkers in normotensive acute pulmonary embolism patients: an observational study. Anatol J Cardiol. 2013; 13(2): 108-114


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