%0 Journal Article
%T Helical computerized tomography and NT-proBNP for screening of right ventricular overload on admission and at long term follow-up of acute pulmonary embolism
%A Mia K Laiho
%A Veli-Pekka Harjola
%A Marit Graner
%A Anneli Piilonen
%A Merja Raade
%A Pirjo Mustonen
%J Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
%D 2012
%I BioMed Central
%R 10.1186/1757-7241-20-33
%X Sixty-three non-high risk APE patients were studied. RVD was assessed at admission in the emergency department by CT and TTE, and both NT-proBNP and TnT samples were taken. These, excepting CT, were repeated seven months later.At admission RVD was detected by CT in 37 (59 %) patients. RVD in CT correlated strongly with RVD in TTE (p < 0.0001). NT-proBNP was elevated (¡Ý 350 ng/l) in 32 (86 %) patients with RVD but in only seven (27 %) patients without RVD (p < 0.0001). All the patients survived until the 7-month follow-up. TTE showed persistent RVD in 6 of 63 (10 %) patients who all had RVD in CT at admission. All of them had elevated NT-proBNP levels in the follow-up compared with 5 (9 %) of patients without RVD (p < 0.0001).TTE does not confer further benefit when helical CT is used for screening for RVD in non-high risk APE. All the patients who were found to have RVD in TTE at seven months follow-up had had RVD in the acute phase CT as well. Thus, patients without RVD in diagnostic CT do not seem to require further routine follow-up to screen for RVD later. On the other hand, persistent RVD and thus need for TTE control can be ruled out by assessment of NT-proBNP at follow-up. A follow-up protocol based on these findings is suggested.
%K Non-high risk pulmonary embolism
%K Follow-up
%K right ventricular dysfunction
%K NT-pro-BNP
%K Echocardiography
%K helical CT
%K CT pulmonary angiography
%U http://www.sjtrem.com/content/20/1/33/abstract