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
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.
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.
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Acute Coronary Syndromes, Cardiology, Coronary Heart Disease, Emergency Medicine.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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