Diagnostic implications of elevated levels of smooth-muscle myosin heavy-chain protein in acute aortic dissection. The smooth muscle myosin heavy chain study.
作者信息
Suzuki T, Katoh H, Tsuchio Y, Hasegawa A, Kurabayashi M, Ohira A, Hiramori K, Sakomura Y, Kasanuki H, Hori S, Aikawa N, Abe S, Tei C, Nakagawa Y, Nobuyoshi M, Misu K, Sumiyoshi T, Nagai R
机构信息
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
出版信息
Ann Intern Med. 2000 Oct 3;133(7):537-41. doi: 10.7326/0003-4819-133-7-200010030-00013.
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.
DESIGN
Cross-sectional study.
SETTING
8 major cardiovascular centers in Japan.
PATIENTS
95 patients with acute aortic dissection, 48 patients with acute myocardial infarction, and 131 healthy volunteers.
MEASUREMENTS
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.
Zotero 插件