| Correlation of heart-type fatty acid-binding protein with mortality and echocardiographic data in patients with pulmonary embolism at intermediate risk. | |
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MedLine Citation:
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PMID: 20691835 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The management strategy in patients presenting with pulmonary embolism at intermediate risk still remains controversial. Our aim was to determine the role of heart-type fatty acid-binding protein (H-FABP) in this patient population. METHODS: One hundred one consecutive patients with confirmed pulmonary embolism and echocardiographic signs of right ventricular overload but without evidence for hypotension or shock, referred to as pulmonary embolism at intermediate risk, were included in the study. Heart-type fatty acid-binding protein and other biomarkers were measured in all patients upon arrival in the emergency department. RESULTS: Of the included 101 patients, 14 had positive H-FABP tests. Ten patients with positive H-FABP (71%) had clinical deterioration during the hospital course and required inotropic support and 8 of these patients died. None of the 87 patients with a negative test worsened or needed inotropic support or died during hospital stay (P < .005). In the H-FABP-positive group, right ventricular function on echocardiography was more impaired (tricuspid annular plane systolic excursion 13 +/- 4 vs 18 +/- 4 mm, RV/LV ratio 1.1 +/- 0.2 vs 0.9 +/- 0.2, presence of paradoxical septal movement 79% vs 46%, presence of McConnell sign 100% vs 60%, respectively, all P < .05) compared to the H-FABP-negative group. After adjusting for potential confounding parameters, in multivariate analysis, H-FABP was the only independent predictor of mortality. CONCLUSIONS: Heart-type fatty acid-binding protein significantly predicts mortality in patients with pulmonary embolism at intermediate risk. Furthermore, it is significantly associated with impaired right ventricular function and shows better correlation with mortality than troponin I. It may be a novel prognostic parameter enabling the optimization of management strategy in the very difficult population of pulmonary embolism at intermediate risk. |
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Authors:
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Alessandra Boscheri; Carsten Wunderlich; Martin Langer; Steffen Schoen; Bärbel Wiedemann; Dirk Stolte; Gesa Elmer; Peggy Barthel; Ruth H Strasser |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American heart journal Volume: 160 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-09 Completed Date: 2010-09-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: 294-300 Citation Subset: AIM; IM |
Copyright Information:
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Copyright 2010 Mosby, Inc. All rights reserved. |
Affiliation:
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Medical Clinic, Department of Cardiology, University of Technology Dresden, Dresden, Germany. aboscheri@hotmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Biological Markers / blood* Fatty Acid-Binding Proteins / blood* Female Humans Kaplan-Meiers Estimate Logistic Models Male Middle Aged Multivariate Analysis Prognosis Pulmonary Embolism / blood*, mortality, physiopathology Risk Assessment Troponin I / blood Ventricular Dysfunction, Right / ultrasonography Ventricular Function |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Fatty Acid-Binding Proteins; 0/Troponin I |
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