scholarly journals High serum VE-cadherin and vinculin concentrations are markers of the disruption of vascular integrity during acute aortic dissection

2021 ◽  
Author(s):  
Shiyue Wang ◽  
Yuchen He ◽  
Xin Li ◽  
Shijie Xin ◽  
Jian Zhang ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Diagnostic Value ◽  
Serum Markers ◽  
High Serum ◽  
Vascular Endothelial ◽  
Characteristic Analysis ◽  
Vascular Integrity ◽  
Refractory Pain ◽  
Visceral Malperfusion

Abstract Background In the present study, we measured the serum vascular endothelial cadherin (VEC) and vinculin (Vcn) concentrations in patients with acute aortic dissection (AAD) to evaluate their diagnostic value for this condition. Methods One hundred patients with AAD and 60 matched controls were included in the study. The serum concentrations of VEC and Vcn were measured using enzyme-linked immunosorbent assays. Results The serum VEC and Vcn concentrations were significantly higher in participants with AAD than in healthy controls. Receiver operating characteristic analysis generated areas under the curves for VEC and Vcn that were diagnostic for AAD (0.604 and 0.665, respectively). The optimal cut-off values were 3.986 ng/µL and 128.1 pg/mL, the sensitivities were 43.0% and 35.0%, and the specificities were 73.3% and 90.0%, respectively. In addition, the use of a combination of serum VEC and Vcn increased the AUC to 0.739, with a sensitivity of 56.0% and a specificity of 76.7%. A high serum Vcn concentration was associated with a higher risk of poor visceral malperfusion in participants with AAD (odds ratio [OR] = 1.007, 95% confidence interval [CI]: 1.001–1.013, p = 0.014). In participants with refractory pain, the adjusted OR for the serum VEC concentration increased to 1.172 (95% CI: 1.010–1.361; p = 0.036), compared with participants without refractory pain. Conclusion This study is the first to show the diagnostic value of serum VEC and Vcn for AAD and their relationships with the clinical characteristics of patients with AAD. Thus, VEC and Vcn are potential serum markers of AD.

Response to letter from Jiang: The diagnostic value of combined D-dimer with other indicators in suspected acute aortic dissection patients

2018 ◽  
Vol 267 ◽  
pp. 196
Author(s):  
Kenichi Nitta ◽  
Hiroshi Imamura ◽  
Yuichiro Kashima ◽  
Hiroshi Kamijo ◽  
Michitaro Ichikawa ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Diagnostic Value ◽  
D Dimer

scholarly journals Acute Aortic Dissection Biomarkers Identified Using Isobaric Tags for Relative and Absolute Quantitation

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Ziya Xiao ◽  
Yuan Xue ◽  
Chenling Yao ◽  
Guorong Gu ◽  
Yaping Zhang ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Sensitivity And Specificity ◽  
Acute Aortic Dissection ◽  
Roc Curves ◽  
Diagnostic Value ◽  
Serum Samples ◽  
Absolute Quantitation ◽  
Isobaric Tags ◽  
Diagnostic Sensitivity And Specificity ◽  
D Dimer

The purpose of this study was to evaluate the utility of potential serum biomarkers for acute aortic dissection (AAD) that were identified by isobaric Tags for Relative and Absolute Quantitation (iTRAQ) approaches. Serum samples from 20 AAD patients and 20 healthy volunteers were analyzed using iTRAQ technology. Protein validation was performed using samples from 120 patients with chest pain. A total of 355 proteins were identified with the iTRAQ approach; 164 proteins reached the strict quantitative standard, and 125 proteins were increased or decreased more than 1.2-fold (64 and 61 proteins were up- and downregulated, resp.). Lumican, C-reactive protein (CRP), thrombospondin-1 (TSP-1), and D-dimer were selected as candidate biomarkers for the validation tests. Receiver operating characteristic (ROC) curves show that Lumican and D-dimer have diagnostic value (area under the curves [AUCs] 0.895 and 0.891,P<0.05). For Lumican, the diagnostic sensitivity and specificity were 73.33% and 98.33%, while the corresponding values for D-dimer were 93.33% and 68.33%. For Lumican and D-dimer AAD combined diagnosis, the sensitivity and specificity were 88.33% and 95%, respectively. In conclusion, Lumican has good specificity and D-dimer has good sensitivity for the diagnosis of AAD, while the combined detection of D-dimer and Lumican has better diagnostic value.

scholarly journals The diagnostic value of D-dimer in acute aortic dissection: a meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jian Yao ◽  
Tao Bai ◽  
Bo Yang ◽  
Lizhong Sun
Keyword(s):  
Aortic Dissection ◽  
Likelihood Ratio ◽  
Acute Aortic Dissection ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Diagnostic Value ◽  
Cochrane Library ◽  
Operating Characteristics ◽  
Meta Regression ◽  
D Dimer

Abstract Objective This study aims to evaluate the diagnostic value of D-dimer for acute aortic dissection (AAD) by the method of meta-analysis. Methods PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang databases from the establishment of the databases to December 2020 were systematically searched, and the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) system was used to evaluate the quality of the literature. STATA 15.0 software was applied to calculate the pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (+LR), negative likelihood ratio (−LR) to draw summary receiver operating characteristics (SROC) curve and calculate the area under the curve (AUC). Meta-regression and subgroup analyses were used to explore the source of heterogeneity. Results A total of 16 clinical studies were enrolled in this study, including 1135 patients. The results of the meta-analysis showed that the pooled sensitivity was 0.96 (95% CI 0.91–0.98), the pooled specificity was 0.70 (95% CI 0.57–0.81), and the pooled DOR was 56.57 (95% CI 25.11–127.44), the pooled +LR was 3.25 (95% CI 2.18–4.85), the pooled −LR was 0.06 (95% CI 0.03–0.12), and the AUC was 0.94 (95% CI 0.91–0.95). Meta-regression and subgroup analysis results showed that publication year, sample size and cutoff value might be sources of heterogeneity. When the concentration of D-dimer was less than or equal to 500 ng/ml, the sensitivity significantly increased. Conclusion D-dimer has an excellent diagnostic value for AAD. It is a useful tool for detecting suspected AAD because of the excellent pooled sensitivity. D-dimer ≤ 500 ng/ml increases the potential to identify the suspected patients with AAD.

Vascular endothelial growth factor tyrosine kinase inhibitor targeted therapy: a potential cause of an acute aortic dissection lesser known to the emergency physician

2021 ◽  
Vol 14 (10) ◽  
pp. e245653
Author(s):  
Jocelyn Ting ◽  
Zhiwen Joseph Lo
Keyword(s):  
Risk Factors ◽  
Vascular Endothelial Growth Factor ◽  
Targeted Therapy ◽  
Growth Factor ◽  
Aortic Dissection ◽  
Tyrosine Kinase Inhibitor ◽  
Acute Aortic Dissection ◽  
Kinase Inhibitor ◽  
Vascular Endothelial ◽  
Endothelial Growth Factor

A 59-year-old Chinese male presented to the emergency department with acute onset epigastric pain. He had no cardiovascular risk factors and was only on targeted therapy, pazopanib, for newly diagnosed metastatic renal clear cell carcinoma. He was found to have a Stanford type B acute aortic dissection with moderately elevated systolic blood pressure of 150 mm Hg. Although not a listed side effect, various case reports have shown a potential association between the use of vascular endothelial growth factor tyrosine kinase inhibitor targeted therapy and an acute aortic dissection. It would be prudent to consider the possibility of an aortic dissection in patients on such drugs with suspicious clinical presentation, even in the absence of other risk factors.

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