Original Research Pulmonary Embolism:  CT Signs and Cardiac Biomarkers for Predicting Right Ventricular Dysfunction

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; 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