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(Circulation. 1996;93:1244-1249.)
© 1996 American Heart Association, Inc.

Articles

Novel Biochemical Diagnostic Method for Aortic Dissection

Results of a Prospective Study Using an Immunoassay of Smooth Muscle Myosin Heavy Chain

Toru Suzuki, MD; Hirohisa Katoh, PhD; Masafumi Watanabe, MD; Masahiko Kurabayashi, MD; Katsuhiko Hiramori, MD; Shingo Hori, MD; Masakiyo Nobuyoshi, MD; Hiromitsu Tanaka, MD; Kazuhisa Kodama, MD; Hikaru Sato, MD; Shin Suzuki, MD; Yasuhiro Tsuchio, MD; Yoshio Yazaki, MD; Ryozo Nagai, MD

From the Third Department of Internal Medicine, Faculty of Medicine, University of Tokyo (T.S., M.W., M.K., Y.Y.); Immunology Laboratory, Diagnostics Division, Yamasa Corporation, Chiba (H.K.); Second Department of Internal Medicine, Iwate Medical University (K.H.); Department of Emergency Medicine, Keio University School of Medicine, Tokyo (S.H.); Department of Cardiology, Kokura Memorial Hospital, Fukuoka (M.N.); First Department of Internal Medicine, Faculty of Medicine, Kagoshima University (H.T.); Cardiovascular Division, Osaka Police Hospital (K.K.); Department of Cardiology, Hiroshima City Hospital (H.S.); Department of Cardiology, Sakakibara Heart Institute, Tokyo (S.S.); and Second Department of Internal Medicine, Gunma University School of Medicine (Y.T., R.N.), Japan.

Background Aortic dissection is one of the most common aortic catastrophes. Although newer diagnostic methods as exemplified by image diagnostic techniques have greatly improved the diagnosis of aortic dissection, the diagnosis is still frequently missed today because the signs and symptoms of the disease are at times obscure. A reliable biochemical diagnostic method for aortic dissection would be beneficial.

Methods and Results A novel biochemical diagnostic method for diagnosis of aortic dissection was developed that uses an immunoassay of monoclonal antibodies to smooth muscle myosin heavy chain. A prospective study was conducted to ascertain the usefulness of the method in the diagnosis of aortic dissection. Twenty-seven patients with aortic dissection admitted within the first 24 hours after onset were enrolled. Serial assay of serum smooth muscle myosin heavy chain showed significant elevations within the first 24 hours after onset of aortic dissection, with levels exceeding 10 ng/mL, with subsequent rapid reductions. The sensitivity of the assay within the first 12 hours was 90%, with a specificity of 97%. Analysis of 65 patients with acute myocardial infarction showed that the method could accurately differentiate myocardial infarction from aortic dissection.

Conclusions The immunoassay of serum smooth muscle myosin heavy chain is a rapid and reliable biochemical method in the diagnosis of aortic dissection. The potential use of the method in clinical medicine is promising.

Key Words: aorta • myosin • muscle, smooth

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