PT - JOURNAL ARTICLE AU - T. Henzler AU - S. Roeger AU - M. Meyer AU - U.J. Schoepf AU - J.W. Nance, Jr. AU - D. Haghi AU - W.E. Kaminski AU - M. Neumaier AU - S.O. Schoenberg AU - C. Fink TI - Pulmonary embolism: ct signs and cardiac biomarkers for predicting right ventricular dysfunction AID - 10.1183/09031936.00088711 DP - 2011 Jan 01 TA - European Respiratory Journal PG - erj00887-2011 4099 - http://erj.ersjournals.com/content/early/2011/09/29/09031936.00088711.short 4100 - http://erj.ersjournals.com/content/early/2011/09/29/09031936.00088711.full AB - To prospectively evaluate the accuracy of quantitative cardiac CT parameters and two cardiac biomarkers (NT-pro-Brain Natriuretic Peptide (NT-pro-BNP); troponin I), alone and in combination, for predicting right ventricular dysfunction (RVD) in patients with acute pulmonary embolism (PE). 557 consecutive patients with suspected PE underwent pulmonary CTA. Patients with PE also underwent echocardiography and NT-pro-BNP/troponin I serum level measurements. 3 different CT measurements were obtained (RV/LVaxial, RV/LV4-CH), and RV/LVvolume). CT measurements and NT-pro-BNP/troponin I serum levels were correlated with RVD at echocardiography. Patients with RVD (n=77) showed significantly higher RV/LV ratios and NT-pro-BNP/troponin I levels compared to those without RVD (RV/LVaxial 1.68±0.84 vs. 1.00±0.21; RV/LV4ch 1.52±0.45 vs. 1.01±0.21; RV/LVvolume 1.97±0.53 vs. 1.07±0.52; serum NT-pro-BNP 6372±2319 vs. 1032±1559 ng·L−1; troponin I 0.18±0.41 vs. 0.06±0.18). The area under the curve for the detection of RVD of RV/LVaxial, RV/LV4Ch, RV/LVvolume, NT-pro-BNP and troponin I were 0.84, 0.87, 0.93, 0.83 and 0.70 respectively. The combination of biomarkers and RV/LVvolume increased the AUC to 0.95 (RV/LVvolume with NT-pro-BNP) and 0.93 (RV/LVvolume with troponin I). RV/LVvolume is the most accurate CT parameter for identifying patients with RVD. A combination of RV/LVvolume with NT-pro-BNP or troponin I measurements improves the diagnostic accuracy of either test alone.