title: Diagnostic implications of elevated levels of smooth-muscle myosin heavy-chain protein in acute aortic dissection. The smooth muscle myosin heavy chain study.
abstract: 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.
authors.affiliation: 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
authors.forename: T
authors.initials: T
authors.lastname: Suzuki
authors.forename: H
authors.initials: H
authors.lastname: Katoh
authors.forename: Y
authors.initials: Y
authors.lastname: Tsuchio
authors.forename: A
authors.initials: A
authors.lastname: Hasegawa
authors.forename: M
authors.initials: M
authors.lastname: Kurabayashi
authors.forename: A
authors.initials: A
authors.lastname: Ohira
authors.forename: K
authors.initials: K
authors.lastname: Hiramori
authors.forename: Y
authors.initials: Y
authors.lastname: Sakomura
authors.forename: H
authors.initials: H
authors.lastname: Kasanuki
authors.forename: S
authors.initials: S
authors.lastname: Hori
authors.forename: N
authors.initials: N
authors.lastname: Aikawa
authors.forename: S
authors.initials: S
authors.lastname: Abe
authors.forename: C
authors.initials: C
authors.lastname: Tei
authors.forename: Y
authors.initials: Y
authors.lastname: Nakagawa
authors.forename: M
authors.initials: M
authors.lastname: Nobuyoshi
authors.forename: K
authors.initials: K
authors.lastname: Misu
authors.forename: T
authors.initials: T
authors.lastname: Sumiyoshi
authors.forename: R
authors.initials: R
authors.lastname: Nagai
mesh_terms: 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
chemical_list: D009218:Myosins