Elsevier

The Annals of Thoracic Surgery

Volume 90, Issue 5, November 2010, Pages 1735-1742
The Annals of Thoracic Surgery

Review
In Search of Blood Tests for Thoracic Aortic Diseases

https://doi.org/10.1016/j.athoracsur.2010.04.111Get rights and content

A number of new diagnostic screening tools have been developed for the assessment of acute and chronic diseases of the thoracic aorta. Although standardized blood-based tests capable of detecting individuals at risk for aortic aneurysm and dissection disease are not yet available, our current knowledge is expanding at a rapid rate and the future is very promising. In this review, an update of the contemporary knowledge on blood tests for detecting thoracic aortic diseases in both preclinical and clinical settings is provided, offering the potential to predict adverse aortic events, such as enlargement, rupture, and dissection.

Section snippets

Material and Methods

For this review, we queried the PubMed and the Cochrane Library CENTRAL and EMBASE databases using the key words aortic aneurysm, aortic dissection, diagnosis, and biomarkers.

Conclusions

The rapidly aging patient population in Western societies and the resultant increase in aortic disease, coupled with the unpredictably virulent clinical nature of aortic aneurysm, cry out for advances in biomarker detection of aneurysm activity. Several biochemical markers potentially may be predictive of clinical disease (Table 1). Practical limitations to implementation of biomarker-based diagnosis and prediction relate to the need that potential candidate assays be readily employable in

References (89)

  • D.C. Iliopoulos et al.

    Ascending thoracic aortic aneurysms are associated with compositional remodeling and vessel stiffening but not weakening in age-matched subjects

    J Thorac Cardiovasc Surg

    (2009)
  • J. Satta et al.

    Increased turnover of collagen in abdominal aortic aneurysms, demonstrated by measuring the concentration of the aminoterminal propeptide of type III procollagen in peripheral and aortal blood samples

    J Vasc Surg

    (1995)
  • K. Wilson et al.

    Relationship between abdominal aortic aneurysm wall compliance and clinical outcome: a preliminary analysis

    Eur J Vasc Endovasc Surg

    (1998)
  • V.A. Davis et al.

    Cytokine pattern in aneurysmal and occlusive disease of the aorta

    J Surg Res

    (2001)
  • U. Schonbeck et al.

    T(H)2 predominant immune responses prevail in human abdominal aortic aneurysm

    Am J Pathol

    (2002)
  • J. Dawson et al.

    Aortic aneurysms secrete interleukin-6 into the circulation

    J Vasc Surg

    (2007)
  • R.K. Middleton et al.

    The pro-inflammatory and chemotactic cytokine microenvironment of the abdominal aortic aneurysm wall: a protein array study

    J Vasc Surg

    (2007)
  • G. Albornoz et al.

    Familial thoracic aortic aneurysms and dissections—incidence, modes of inheritance, and phenotypic patterns

    Ann Thorac Surg

    (2006)
  • S. Kakko et al.

    Candidate locus analysis of familial ascending aortic aneurysms and dissections confirms the linkage to the chromosome 5q13–14 in Finnish families

    J Thorac Cardiovasc Surg

    (2003)
  • H. Domanovits et al.

    Acute phase reactants in patients with abdominal aortic aneurysm

    Atherosclerosis

    (2002)
  • K. Yasojima et al.

    Human neurons generate C-reactive protein and amyloid P: upregulation in Alzheimer's disease

    Brain Res

    (2000)
  • K. Yasojima et al.

    Generation of C-reactive protein and complement components in atherosclerotic plaques

    Am J Pathol

    (2001)
  • C. Tribouilloy et al.

    Fibrinogen is an independent marker for thoracic aortic atherosclerosis

    Am J Cardiol

    (1998)
  • J.S. Lindholt et al.

    Relationships between activators and inhibitors of plasminogen, and the progression of small abdominal aortic aneurysms

    Eur J Vasc Endovasc Surg

    (2003)
  • M. Schillinger et al.

    Lipoprotein (a) in patients with aortic aneurysmal disease

    J Vasc Surg

    (2002)
  • M. Peltier et al.

    Elevated serum lipoprotein(a) level is an independent marker of severity of thoracic aortic atherosclerosis

    Chest

    (2002)
  • J.S. Lindholt

    Screening for abdominal aortic aneurysms

    Eur J Vasc Endovasc Surg

    (2003)
  • D.J. Adam et al.

    Hemostatic markers before operation in patients with acutely symptomatic nonruptured and ruptured infrarenal abdominal aortic aneurysm

    J Vasc Surg

    (2002)
  • D.J. Adam et al.

    Coagulation and fibrinolysis in patients undergoing operation for ruptured and nonruptured infrarenal abdominal aortic aneurysms

    J Vasc Surg

    (1999)
  • V. Treska et al.

    Plasma endothelin levels in patients with abdominal aortic aneurysms

    Eur J Vasc Endovasc Surg

    (1999)
  • J. Tateishi et al.

    Hepatocyte growth factor as a potential predictor of the presence of atherosclerotic aorto-iliac artery disease

    Am Heart J

    (2002)
  • N. Konecky et al.

    Correlation between plasma homocyst(e)ine and aortic atherosclerosis

    Am Heart J

    (1997)
  • C.M. Tribouilloy et al.

    Plasma homocysteine and severity of thoracic aortic atherosclerosis

    Chest

    (2000)
  • P. Matt et al.

    Recent advances in understanding Marfan syndrome: should we now treat surgical patients with losartan?

    J Thorac Cardiovasc Surg

    (2008)
  • Y. Seino et al.

    Use of a whole blood rapid panel test for heart-type fatty acid-binding protein in patients with acute chest pain: comparison with rapid troponin T and myoglobin tests

    Am J Med

    (2003)
  • C.A. Nienaber et al.

    The diagnosis of thoracic aortic dissection by noninvasive imaging procedures

    N Engl J Med

    (1993)
  • T. Suzuki et al.

    Novel biochemical diagnostic method for aortic dissectionResults of a prospective study using an immunoassay of smooth muscle myosin heavy chain

    Circulation

    (1996)
  • S.Z. Goldhaber et al.

    Quantitative plasma D-dimer levels among patients undergoing pulmonary angiography for suspected pulmonary embolism

    JAMA

    (1993)
  • V. Costantini et al.

    Fibrin and cancer

    Thromb Haemost

    (1993)
  • F. Nomura et al.

    Changes in coagulation condition, cytokine, adhesion molecule after repair of type A aortic dissection

    Eur J Cardiothorac Surg

    (2004)
  • K. Iyano et al.

    Correlation of hemostatic molecular markers and morphology of the residual false lumen in chronic aortic dissection

    Ann Thorac Cardiovasc Surg

    (2004)
  • T. Suzuki et al.

    Diagnosis of acute aortic dissection by D-dimer: the International Registry of Acute Aortic Dissection Substudy on Biomarkers (IRAD-Bio) experience

    Circulation

    (2009)
  • F. Serino et al.

    Noninvasive diagnosis of incomplete endovascular aneurysm repair: D-dimer assay to detect type I endoleaks and nonshrinking aneurysms

    J Endovasc Ther

    (2002)
  • N. Vine et al.

    Metalloproteinases in degenerative aortic disease

    Clin Sci (Lond)

    (1991)
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