Diagnostic implications of elevated levels of smooth-muscle myosin heavy-chain protein in acute aortic dissection. The smooth muscle myosin heavy chain study.
BACKGROUND
A rapid 30-minute assay of circulating smooth-muscle myosin heavy-chain protein has been developed as a biochemical diagnostic tool for aortic dissection.


OBJECTIVE
To determine the sensitivity and specificity of this assay.


METHODS
Cross-sectional study.


METHODS
8 major cardiovascular centers in Japan.


METHODS
95 patients with acute aortic dissection, 48 patients with acute myocardial infarction, and 131 healthy volunteers.


METHODS
Levels of circulating smooth-muscle myosin heavy-chain protein.


RESULTS
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 microgram/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 microgram/L).


CONCLUSIONS
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
T
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. torusuzu-tky@umin.ac.jp
Katoh
H
H
Tsuchio
Y
Y
Hasegawa
A
A
Kurabayashi
M
M
Ohira
A
A
Hiramori
K
K
Sakomura
Y
Y
Kasanuki
H
H
Hori
S
S
Aikawa
N
N
Abe
S
S
Tei
C
C
Nakagawa
Y
Y
Nobuyoshi
M
M
Misu
K
K
Sumiyoshi
T
T
Nagai
R
R
D000368:Aged; D001019:Aortic Rupture / Q000097:blood* / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000378:metabolism*; D009218:Myosins / Q000097:blood*; D012680:Sensitivity and Specificity
D009218:Myosins