Cetiner Mehmet Ali, Sayın Muhammet Raşit, Yıldırım Nesligül, Karabağ Turgut, Aydın Mustafa
Zonguldak Karadeniz Ereğli Devlet Hastanesi, Kardiyoloji Kliniği, Zonguldak, Turkey.
Anadolu Kardiyol Derg. 2013 Mar;13(2):108-14. doi: 10.5152/akd.2013.033. Epub 2012 Dec 7.
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).
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), myocardial 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.
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.
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.
本研究旨在调查血流动力学稳定的急性肺栓塞（APE）患者的收缩期和舒张期偏心指数与心脏生物标志物之间的关联。
本横断面观察性研究纳入了30例血流动力学稳定（收缩压>90 mmHg）的APE患者（17例男性，平均年龄61.67±17.6岁）。研究了血清肌钙蛋白I、D-二聚体、脑钠肽（BNP）和心脏型脂肪酸结合蛋白（hFABP）水平与收缩期和舒张期偏心指数、三尖瓣环平面收缩期位移（TAPSE）、心肌性能指数（MPI）、收缩期肺动脉压和下腔静脉指数之间的关联。根据数据分布，采用Pearson和Spearman相关性分析评估参数之间的关系。
相关性分析显示，心脏生物标志物与超声心动图测量之间最显著的关系存在于BNP值中。同时，发现收缩期和舒张期偏心指数与血清肌钙蛋白I（分别为r=0.470，p=0.009/r=0.310，p=0.095）和BNP（分别为r=0.402，p=0.028/r=0.384，p=0.036）值具有显著相关性。另一方面，D-二聚体水平升高在任何超声心动图参数中均未导致统计学显著性。
根据我们的结果，hFABP在血压正常的APE患者中很少呈阳性。单独升高的D-二聚体在预测右心室功能不全方面不显著。偏心指数与BNP和肌钙蛋白I值显示出显著关系。所得结果表明，早期超声心动图评估对心脏生物标志物异常的患者很重要。
