NOVEL BIOCHEMICAL DIAGNOSTIC METHOD FOR AORTIC DISSECTION - RESULTS OF A PROSPECTIVE-STUDY USING AN IMMUNOASSAY OF SMOOTH-MUSCLE MYOSIN HEAVY-CHAIN

Background Aortic dissection is one of the most common aortic catastro phes. Although newer diagnostic methods as exemplified by image diagno stic techniques have greatly improved the diagnosis of aortic dissecti on, the diagnosis is still frequently missed today because the signs a nd symptoms of the disease are at times obscure. A reliable biochemica l diagnostic method for aortic dissection would be beneficial. Methods and Results A novel biochemical diagnostic method for diagnosis of ao rtic dissection was developed that uses an immunoassay of monoclonal a ntibodies 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 adm itted within the first 24 hours after onset were enrolled. Serial assa y of serum smooth muscle myosin heavy chain showed significant elevati ons within the first 24 hours after onset of aortic dissection, with l evels exceeding 10 ng/mL, with subsequent rapid reductions. The sensit ivity of the assay within the first 12 hours was 90%, with a specifici ty of 97%. Analysis of 65 patients with acute myocardial infarction sh owed that the method could accurately differentiate myocardial infarct ion from aortic dissection. Conclusions The immunoassay of serum smoot h muscle myosin heavy chain is a rapid and reliable biochemical method in the diagnosis of aortic dissection. The potential use of the metho d in clinical medicine is promising.