Current imaging techniques and potential biomarkers in the diagnosis of acute aortic dissection

Area of Science:

• Cardiovascular Medicine
• Diagnostic Imaging
• Biomarker Discovery

Background:

• Acute dissection of the thoracic aorta (AAD) presents high morbidity and mortality, with outcomes unchanged over the last decade.
• Current diagnostic methods for AAD, primarily imaging, are time-consuming, not always accessible, and lack optimal sensitivity and specificity.
• There is a critical need for improved diagnostic tools to facilitate prompt identification and management of AAD.

Purpose of the Study:

• To review current imaging modalities used for diagnosing AAD.
• To discuss the potential role of biochemical markers in aiding AAD detection.
• To explore emerging biomarkers showing promise for AAD management.

Main Methods:

• Review of established imaging techniques: chest radiograph, echocardiography, computed tomography (CT), and magnetic resonance imaging (MRI).
• Analysis of the utility and limitations of current biomarkers like D-dimer and C-reactive protein in AAD diagnosis.
• Examination of recently proposed biomarkers, including smooth muscle myosin heavy chain, calponin, soluble elastin fragments, and transforming growth factor β.

Main Results:

• Imaging remains the primary diagnostic approach for AAD, but faces technical and logistical constraints.
• Existing biomarkers (e.g., D-dimer, CRP) are often underutilized due to non-specific findings in AAD.
• Several novel biomarkers have demonstrated promising results in preliminary studies for AAD detection.

Conclusions:

• Despite limitations, imaging is currently indispensable for AAD diagnosis.
• Non-specific biomarkers like D-dimer and CRP have limited value alone.
• Emerging biomarkers hold significant potential to enhance the diagnostic accuracy and timely management of AAD.