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Published on: September 8, 2023
Biomarkers in aortic dissection
Dan Wen1, Xian-Liang Zhou, Jian-Jun Li
1Department of Cardiology, Fu Wai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing 100037, China.
Insights
Biomarkers in the blood can aid in diagnosing and classifying aortic dissection (AD), a serious cardiovascular condition. These markers also help guide treatment and predict patient outcomes for aortic dissection.
Area of Science:
- Cardiovascular Medicine
- Biomarker Research
- Pathophysiology
Background:
- Aortic dissection (AD) is a critical cardiovascular disease with high mortality rates.
- Pathologically, AD involves blood entering the aortic media, leading to inflammation, cell apoptosis, and structural degradation.
- This process can result in aortic dilatation, aneurysm formation, and rupture.
Purpose of the Study:
- To review the clinical implications of peripheral blood biomarkers in aortic dissection.
- To highlight the role of biomarkers in early diagnosis, classification, treatment guidance, and prognosis prediction for AD.
Main Methods:
- Literature review of studies investigating biomarkers in aortic dissection.
- Analysis of current research on the diagnostic and prognostic value of various biomarkers.
- Synthesis of information on the role of biomarkers in guiding AD management.
Main Results:
- Several peripheral blood biomarkers, including C-reactive protein (CRP), matrix metalloproteinases (MMPs), and D-dimer, show significant roles in AD evaluation.
- These biomarkers are crucial for early diagnosis and classification of aortic dissection.
- Biomarkers can also inform treatment strategies and predict prognosis in patients with AD.
Conclusions:
- Peripheral blood biomarkers are essential tools for the comprehensive management of aortic dissection.
- Further research into these markers can improve patient outcomes and therapeutic approaches for AD.
- Biomarker analysis offers valuable insights into the pathophysiology and clinical course of aortic dissection.
Abstract:
Aortic dissection (AD) is a severe cardiovascular disease with high mortality and morbidity, which is characterized by acute onset and rapid progress. Mechanically, it has been considered that circulating blood flows into the media of the aorta through the rupture of the intima forming true and false lumens. Generally, its pathologic process is considered as follows: initially, inflammatory reaction, inflammatory cells infiltration in aortic wall, and then apoptosis of vascular smooth muscle cells, degenerating of aortic media, elastin fracture, and degradation. At last, the ingredients of the aorta are destroyed and lead to aortic dilatation, aneurysm formation, dissection and rupture. Currently, several biomarkers in peripheral blood including C-reactive protein (CRP), matrix metalloproteinases (MMPs), soluble elastin fragments (sELAF), D-dimer, smooth muscle myosin heavy chain, calponin, N-terminal pro-brain natriuretic peptide (NT-proBNP), big endothelin-1 (Big ET-1), genetic markers and so on, have been demonstrated to play a major role in evaluation of AD, for example, making early diagnosis and classifying of AD. Additionally, those markers may also guide our treatment therapies and predict the prognosis. The aims of this review mainly focus on the clinical implications of the biomarkers in AD.
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