Key result
Integrated diagnostic algorithms combining clinical probability, biomarkers like D-dimer, and advanced imaging modalities are essential for the timely diagnosis and management of acute aortic syndromes.
Why the study?
Due to overlapping symptoms and signs with other cardiovascular emergencies, diagnosing acute aortic syndromes remains challenging, resulting in time delays and increased morbidity and mortality.
This review summarizes the 35-year Mainz-Essen experience, emphasizing the critical role of integrating advanced imaging and biomarkers for the rapid diagnosis and management of acute aortic syndromes.
Supports integrated imaging-biomarker diagnostics for acute aortic syndromes in experienced centers; leaves open prospective validation and broader adoption.
Acute aortic syndromes (AAS) encompass a group of life-threatening medical conditions (acute aortic dissection [AAD], intramural hematoma, and penetrating aortic ulcer) with a common pathophysiological pathway. Due to overlapping symptoms and signs with other cardiovascular emergencies, the diagnosis remains challenging resulting in time delays and related increased in-hospital and long-term morbidity and mortality. The Cardiovascular Department of Johannes Gutenberg University in Mainz at West-German Heart Centre in Essen (Germany) first described (in 1984) AAD by transesophageal echocardiography, AAD diagnostic features, and furtherly explored the implementation of "invasive" imaging techniques, namely, intravascular ultrasound and intraluminal phased-array imaging. Furthermore, pioneer studies were undertaken on the biomarker and imaging interplay, namely, D-dimer and F-fluorodeoxyglucose positron emission tomography/computed tomography. We discuss the unique 35-year-long Mainz-Essen experience on the diagnostic and prognostic role of serological and imaging biomarkers in AAS.
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Bossone et al. (2021) conducted a review in Acute aortic syndromes. Diagnostic imaging and biomarkers was evaluated. Integrated diagnostic algorithms combining clinical probability, biomarkers like D-dimer, and advanced imaging modalities are essential for the timely diagnosis and management of acute aortic syndromes.
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