The BB-isozyme of creatine kinase has been also investigated as a potential marker for aortic dissection since it is abundantly present both in smooth-muscle fibers and in the neurological system. Analogous to the use of the MB-isozyme of creatine kinase for the detection of cardiac ischemia, a small study has shown that creatine kinase BB-isozyme is elevated in acute aortic dissection15. In addition, the study demonstrated that the temporal profiles of the peak level is delayed compared to smooth-muscle myosin heavy chain. Combined use of the two tests may therefore be extremely useful for temporal profiling of aortic dissection.
Figure 16.3. (a) Plasmatic levels detected by ELISA of metalloproteinase-9 from symptom onset to two months' follow-up in type B aortic dissection. No MMP-9 are measurable in the control population presenting in the emergency room with chest pain.
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