Toru Suzuki, MD; Hirohisa Katoh, PhD; Yasuhiro Tsuchio, MD; Akira Hasegawa, MD; Masahiko Kurabayashi, MD; Atsushi Ohira, MD; Katsuhiko Hiramori, MD; Yasunari Sakomura, MD; Hiroshi Kasanuki, MD; Shingo Hori, MD; Naoki Aikawa, MD; Satoshi Abe, MD; Chuwa Tei, MD; Yoshihisa Nakagawa, MD; Masakiyo Nobuyoshi, MD; Kazuhiko Misu, MD; Tetsuya Sumiyoshi, MD; Ryozo Nagai, MD
A rapid 30-minute assay of circulating smooth-muscle myosin heavy-chain protein has been developed as a biochemical diagnostic tool for aortic dissection.
To determine the sensitivity and specificity of this assay.
8 major cardiovascular centers in Japan.
95 patients with acute aortic dissection, 48 patients with acute myocardial infarction, and 131 healthy volunteers.
Levels of circulating smooth-muscle myosin heavy-chain protein.
Patients with acute aortic dissection who presented within 3 hours after onset had elevated levels of circulating smooth-muscle myosin heavy-chain protein. In these patients, the assay had a sensitivity of 90.9%, a specificity of 98% compared with healthy volunteers, and a specificity of 83% compared with patients who had acute myocardial infarction; the clinical decision limit was 2.5 µg/L. All patients with proximal lesions had elevated levels of smooth-muscle myosin heavy-chain protein, and only patients with distal lesions had decreased levels (<2.5 µg/L).
Levels of smooth-muscle myosin heavy-chain protein can be used to diagnose aortic dissection soon after symptom onset. The assay had the greatest diagnostic value in patients with proximal lesions.
Suzuki T, Katoh H, Tsuchio Y, Hasegawa A, Kurabayashi M, Ohira A, et al. Diagnostic Implications of Elevated Levels of Smooth-Muscle Myosin Heavy-Chain Protein in Acute Aortic Dissection: The Smooth Muscle Myosin Heavy Chain Study. Ann Intern Med. 2000;133:537–541. doi: 10.7326/0003-4819-133-7-200010030-00013
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Published: Ann Intern Med. 2000;133(7):537-541.
Acute Coronary Syndromes, Cardiology, Coronary Heart Disease, Emergency Medicine.
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