In patients with acute pulmonary thromboemboliserum urotensin – II levels

Pulmonary embolism (PE) is a cardiovascular disease with high morbidity and mortality, which is very common in the world, without specific clinical symptoms and signs. Since the mortality of the disease is high, early diagnosis and prompt treatment are required. Therefore, easier, more accessible and less noninvasive additional tests are needed in the diagnosis phase of the disease. Urotensin-II (U-II) used in the study is a vasoactive peptide with many potent effects on the cardiorenovascular system. U-II has effects on vascular smooth muscle cells. The aim of this study is to determine serum U-II levels in PE patients and to investigate whether U-II levels can be used as a diagnostic biomarker, its relationship with right ventricular dysfunction, and its contribution to disease severity and risk classification. The study included 80 cases diagnosed with PE by Computed Tomography Pulmonary Angiography (CTPA) and 40 healthy controls. In the study, PE patients were divided into groups according to their clinical findings at admission, right ventricular findings in radiological imaging, and cardiac biomarkers (troponin I and NTproBNP), and the severity of PSI was calculated and risk classification was made. Group 1 was determined as high risk, group 2 as medium risk, and group 3 as low risk. It was observed that 47.5% of the PE patients included in the study were female and 52.5% were male, and the mean age of the patients was 67.7±16.8. In the healthy control group, the distribution of the participants by gender was 47.5% female and 52.5% male; mean age of control cases was determined as 66.1±11.3. There was no statistically significant difference between PE patients and the control group in terms of gender (p=1,000) and age (p=0.586). In the study, when PE patients were divided into 3 groups; It was observed that 15 patients (18.8%) were in group 1, 29 patients (36.3%) were in group 2, and 36 patients (45%) were in group 3. Mean U-II levels were found to be statistically significantly lower in PE patients compared to the control group. When Urotensin II levels were evaluated by ROC analysis in terms of estimating PE in the study, the area under the curve was determined as 0.746 (95% CI 0.658-0.821; p<0.001). In addition, when the optimal cut-off value of Urotensin II level was determined as 2,108 in terms of predicting PE, its sensitivity was 87.5% and its specificity was 55%. Since PE is an acutely developing inflammatory process, the fact that serum U-II levels are lower in patients with PE compared to the control group may suggest that U-II has a protective effect on the cardiovascular system, but additional studies are needed.