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

Cetiner, Mehmet Ali | Sayin, Muhammet Rasit | Yildirim, Nesligul | Karabag, Turgut | Aydin, Mustafa

Article | 2013 | ANATOLIAN JOURNAL OF CARDIOLOGY13 ( 2 ) , pp.108 - 114

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), myoc . . .ardial 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. (Anadolu Kardiyol Derg 2013; 13: 108-14 Daha fazlası Daha az

Right ventricular isovolumic acceleration in acute pulmonary embolism

Cetiner M.A. | Sayin M.R. | Yildirim N. | Karabag T. | Dogan S.M. | Kucuk E. | Aydin M.

Article | 2014 | Echocardiography31 ( 10 ) , pp.1253 - 1258

Objective: In this study, we examined the role of isovolumic acceleration (IVA) measured with right ventricle (RV) tissue Doppler imaging (TDI) to predict the presence of acute pulmonary embolism (APE) in hemodynamically stable patients with clinical suspicion of APE. Materials and Method: This study included 25 hemodynamically stable (systolic blood pressure >90 mmHg) patients diagnosed with APE for the first time. Twenty-five subjects with similar demographic characteristics in whom APE was excluded due to preexisting clinical suspicion were also enrolled as the control group. All control group subjects were enrolled after prov . . .ed to have no evidence of APE on imaging. Both groups were compared with respect to RV-IVA measured with TDI in addition to conventional echocardiographic parameters. Results: Among the echocardiography parameters, only RV-IVA was impaired in patients with hemodynamically stable APE compared to controls (2.85 [1.37-6.42] m/sec2 vs. 3.32 [2.24-6.52] m/sec2, respectively; P = 0.02). A receiver operating characteristic (ROC) analysis was performed to determine the RV-IVA value to predict clinically suspected APE. A cutoff level of 3.22 m/sec2 had a sensitivity of 64% and a specificity of 60%; a cutoff level of 3.17 m/sec2 had a sensitivity of 64% and a specificity of 64%; and a cutoff level of 3.10 m/sec2 had a sensitivity of 60% and specificity of 64% (ROC area under curve: 0.691, 95% CI: 0.543-0.839, P = 0.02). Conclusion: Results of our study suggest that RV-IVA may be a useful parameter to detect subtle alterations in RV and may predict the presence of APE in hemodynamically stable patients. © 2014, Wiley Periodicals, Inc Daha fazlası Daha az

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