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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2003;23:1839.)
© 2003 American Heart Association, Inc.

Vascular Biology

Soluble Elastin Fragments in Serum Are Elevated in Acute Aortic Dissection

Tadashi Shinohara; Kimihiro Suzuki; Makoto Okada; Masaru Shiigai; Masashi Shimizu; Tadaaki Maehara; Fumitaka Ohsuzu

From the Departments of Internal Medicine I (T.S., K.S., M.O., M. Shiigai, F.O.) and Surgery II (M. Shimizu, T.M.), National Defense Medical College, Saitama, Japan.

Correspondence to Tadashi Shinohara, MD, Internal Medicine I, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan. E-mail kogen{at}me.ndmc.ac.jp

Objective— We aimed to establish an enzyme-linked immunosorbent assay for measuring soluble elastin fragments (sELAF) in serum and to reveal its usefulness in diagnosing acute aortic dissection (AAD).

Methods and Results— An enzyme-linked immunosorbent assay to measure sELAF in serum was developed by using the newly created double monoclonal antibodies, which recognize the different epitopes of human aortic elastin. Twenty-five AAD patients, 50 patients with acute myocardial infarction (AMI), and 474 healthy individuals were enrolled in the study. The sELAF levels from healthy subjects gradually increased with aging. When the cutoff point for positivity was set at the mean+3 SD (ie, 3 SD above the mean in healthy subjects at each age), 16 AAD patients (64.0%) were found be positive, whereas only 1 AMI patient was found to be positive (2.0%). AAD patients with either an open or a partially open pseudolumen were found be 88.9% positive for sELAF, whereas those with its early closure were 0% positive. The difference in the sELAF levels between AAD patients with and without a thrombotic closure of false lumen was significant (60.3±15.6 versus 135.4±53.2 ng/mL, respectively; P<0.005).

Conclusions— The sELAF level in serum may be a useful marker for helping in the diagnosis and screening of AAD and may also help to distinguish AAD from AMI.

Key Words: matrix protein • elastin degradation • aortic media • intimal tear • false lumen

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