Document Detail


Prediction of adverse clinical outcome in patients with acute pulmonary embolism: Evaluation of High-Sensitivity Troponin I and quantitative CT parameters.
MedLine Citation:
PMID:  23238359     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: To evaluate the accuracy of high-sensitivity-cardiac-troponin-I (hs-cTnI) and quantitative CT-parameters, alone and in combination, for predicting right-ventricular-dysfunction (RVD) and adverse clinical outcome in patients with acute pulmonary embolism (PE). MATERIALS AND METHODS: 65 patients with PE and hs-cTnI measurements within 24h of CT were retrospectively included. RVD was assessed on CT by calculating right ventricular/left ventricular (RV/LV) diameter ratios on transverse sections (RV/LVtrans), four-chamber-views (RV/LV4ch), and RV/LV volume ratio (RV/LVvol). Pulmonary CTA-obstruction-scores (OS) (Qanadli, Mastora) were calculated. Receiver operator characteristic (ROC) analysis was performed to compare Hs-cTnI, RV/LV ratios, and OS for predicting adverse clinical outcome (i.e. intensive care treatment, death). RESULTS: 12 patients with PE had adverse clinical outcome and showed significantly higher RV/LV ratios and OS compared to those without. ROC analysis revealed a cutoff value of 0.042ng/mL for hs-cTnI resulting in a sensitivity and specificity of 84% and 92% for predicting adverse clinical outcome, respectively. Elevated hs-cTnI was significantly associated with adverse clinical outcome. In a ROC analysis the AUC for the prediction of adverse clinical outcome of RV/LV4Ch, RV/LVvol, and hs-cTnI were 0.77, 0.76, and 0.71. The combination of hs-cTnI and RV/LV ratios increased the AUC for the prediction of adverse clinical outcome. CONCLUSIONS: Hs-cTnI is associated with adverse clinical outcome in patients with acute PE. A combination of hs-cTnI with quantitative CT-parameters improves the prediction of adverse clinical outcome.
Authors:
Paul Apfaltrer; Thomas Walter; Joachim Gruettner; Frank Weilbacher; Mathias Meyer; Thomas Henzler; Michael Neumaier; Stefan O Schoenberg; Christian Fink
Related Documents :
23238359 - Prediction of adverse clinical outcome in patients with acute pulmonary embolism: evalu...
10366079 - Oral fluorescein angiography with the confocal scanning laser ophthalmoscope.
8659599 - Indocyanine green angiographic findings in vogt-koyanagi-harada disease.
16835649 - Adaptive optics compensation for propagation through deep turbulence: initial investiga...
2387679 - Visualization of the retinal microvasculature by targeted dye delivery.
24852289 - Mr myelography for identification of spinal csf leak in spontaneous intracranial hypote...
11900679 - Advances in imaging for pancreatic disease.
97979 - Computed body tomography in children: evaluation of 45 patients.
21385469 - Imaging in assessing hepatic and peritoneal metastases of gastric cancer: a systematic ...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-10
Journal Detail:
Title:  European journal of radiology     Volume:  -     ISSN:  1872-7727     ISO Abbreviation:  Eur J Radiol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106411     Medline TA:  Eur J Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Germany. Electronic address: Paul.Apfaltrer@medma.uni-heidelberg.de.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Endovascular strategy for unruptured cerebral aneurysms.
Next Document:  Worsening respiratory function in mechanically ventilated intensive care patients: Feasibility and v...