Suzuki Toru, Distante Alessandro, Zizza Antonella, Trimarchi Santi, Villani Massimo, Salerno Uriarte Jorge Antonio, de Luca Tupputi Schinosa Luigi, Renzulli Attilio, Sabino Federico, Nowak Richard, Birkhahn Robert, Hollander Judd E, Counselman Francis, Bossone Eduardo, Eagle Kim
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Eur Heart J. 2008 Jun;29(11):1439-45. doi: 10.1093/eurheartj/ehn162. Epub 2008 Apr 24.
The early diagnosis of acute aortic dissection (AD) remains challenging. We sought to determine the utility of the troponin-like protein of smooth muscle, calponin, as a diagnostic biomarker of acute AD.
Immunoassays against calponin (acidic, basic, and neutral isoforms) were developed and the levels were compared in a convenience sample of 59 patients with radiographically proven AD [34 males, age 59 +/- 15 (SD) years] vs. 158 patients suspected of having AD at presentation (116 males, age 63 +/- 15 years) but whose final diagnosis was not AD. Basic calponin, which is the most specific and abundant in smooth muscle, and acidic calponin, respectively, showed greater than two-fold and three-fold elevations in patients with acute AD. Diagnostic performance as determined by receiver-operating characteristics curve analysis showed that both acidic and basic calponin have the potential to detect AD in the first 24 h [respective areas under the curve (AUCs) 0.63 and 0.58], with superior performance of basic calponin (when compared with acidic) in the initial 6 h (respective AUCs 0.63 and 0.67).
Circulating calponin levels were elevated in acute AD compared with controls. These biomarkers have the potential for use as an early diagnostic biomarker for acute AD.
急性主动脉夹层（AD）的早期诊断仍然具有挑战性。我们试图确定平滑肌肌钙蛋白样蛋白——钙调蛋白，作为急性AD诊断生物标志物的效用。
开发了针对钙调蛋白（酸性、碱性和中性亚型）的免疫测定法，并在59例经影像学证实为AD的患者（34例男性，年龄59±15岁[标准差]）与158例初诊疑似AD但最终诊断不是AD的患者（116例男性，年龄63±15岁）的便利样本中比较了其水平。在平滑肌中最具特异性且含量最丰富的碱性钙调蛋白和酸性钙调蛋白，在急性AD患者中分别显示出两倍和三倍以上的升高。通过受试者操作特征曲线分析确定的诊断性能表明，酸性和碱性钙调蛋白都有可能在最初24小时内检测到AD（曲线下面积[AUCs]分别为0.63和0.58），碱性钙调蛋白在最初6小时内的表现优于酸性钙调蛋白（AUCs分别为0.63和0.67）。
与对照组相比，急性AD患者循环钙调蛋白水平升高。这些生物标志物有潜力用作急性AD的早期诊断生物标志物。
