Correlational analyses between the production of anti-nuclear antibodies and biomarkers of variants intramural hematoma

doi:10.3969/j.issn.1674-490X.2022.05.004

Abstract

Abstract: Objective To investigate the correlation of the incidence of anti-nuclear antibodies(ANAs)positivity and variants intramural hematoma(IMH). Methods 88 patients with a confirmed diagnosis of IMH admitted between November 2018 and July 2020 to Cardiovascular Surgery Department were included as the study group. The control group consisted of 88 age-matched chest pain patients without acute aortic syndrome confirmed by enhanced aortic CT. All patients were tested for ANAs in peripheral blood on the first day after admission. ANAs were detected by immunofluorescence assay. Titers > 1∶100 were regarded as positive for ANAs. Results Among the control subjects, 16(18.18%)were ANAs positive, 3(3.41%)were anti-neutrophil cytoplasmic antibodies(ANCA)positive, and among the study subjects, 48(54.55%)were ANAs positive, 12(13.64%)were ANCA positive.The difference between the two groups was statistically significant. Binary logistic regression analysis showed that atherosclerosis(OR=7.439, 95%CI=1.319-41.965, P=0.023), WBC(OR=2.907, 95%CI=1.812-4.663, P=0.001), D-Dimer(OR=2.942, 95%CI=1.406-6.154, P=0.004), ANAs(OR=13.618, 95% CI=2.437-76.085, P=0.003)and ANCA(OR=0.064, 95% CI=0.005-0.839, P=0.036)were independent risk factors for IMH. Conclusion The proportion of ANAs-positive patients in IMH group is higher than that in control group, and ANAs is an independent risk factor of IMH, which may become an important marker of IMH.

Key words: variants intramural hematoma, antinuclear antibodies, inflammation, atherosclerosis

CLC Number:

ZHANG Jingbo, SHI Jian, YANG Jingyun, RAN Jipeng, LIU Ziteng, ZHANG Shasha. Correlational analyses between the production of anti-nuclear antibodies and biomarkers of variants intramural hematoma[J]. Journal of Hebei Medical College for Continuing Education, 2022, 39(5): 19-24.

References

[1] BOSSONE E, LABOUNTY T M, EAGLE K A. Acute aortic syndromes: diagnosis and management, an update[J]. Eur Heart J, 2018, 39(9): 739-749. DOI: 10.1093/eurheartj/ehx319.
[2] RAMANATH V S, OH J K, SUNDT 3RD T M, et al. Acute aortic syndromes and thoracic aortic aneurysm[J]. Mayo Clin Proc, 2009, 84(5): 465-481. DOI: 10.1016/S0025-6196(11)60566-1.
[3] KUEHL H, EGGEBRECHT H, BOES T, et al. Detection of inflammation in patients with acute aortic syndrome: comparison of FDG-PET/CT imaging and serological markers of inflammation[J]. Heart, 2008, 94(11): 1472-1477. DOI: 10.1136/hrt.2007.127282.
[4] WEINDEL C G, RICHEY L J, BOLLAND S, et al. B cell autophagy mediates TLR7-dependent autoimmunity and inflammation[J]. Autophagy, 2015, 11(7): 1010-1024. DOI: 10.1080/15548627.2015.1052206.
[5] LEONE O, PACINI D, FOÀ A, et al. Redefining the histopathologic profile of acute aortic syndromes: clinical and prognostic implications[J]. J Thorac Cardiovasc Surg, 2018, 156(5): 1776-1785.e6. DOI: 10.1016/j.jtcvs.2018.04.086.
[6] SOLOW E B, VONGPATANASIN W, SKAUG B, et al. Antinuclear antibodies in the general population: positive association with inflammatory and vascular biomarkers but not traditional cardiovascular risk factors[J]. Clin Exp Rheumatol, 2018, 36(6): 1031-1037.
[7] MAZUREK A, IWANIEC T, OLSZOWSKA M, et al. Antiphospholipid and antinuclear antibodies in young patients after myocardial revascularization procedures[J]. Isr Med Assoc J, 2016, 18(3/4):228-231.
[8] PERTOVAARA M, KÄHÖNEN M, JUONALA M, et al. Autoimmunity and atherosclerosis: the presence of antinuclear antibodies is associated with decreased carotid elasticity in young women. The Cardiovascular Risk in Young Finns Study[J]. Rheumatology(Oxford), 2009, 48(12): 1553-1556. DOI: 10.1093/rheumatology/kep288.
[9] GRAINGER D J, BETHELL H W L. High titres of serum antinuclear antibodies, mostly directed against nucleolar antigens, are associated with the presence of coronary atherosclerosis[J]. Ann Rheum Dis, 2002, 61(2): 110-114. DOI: 10.1136/ard.61.2.110.
[10] SONG J K, YIM J H, AHN J M, et al. Outcomes of patients with acute type a aortic intramural hematoma[J]. Circulation, 2009, 120(21): 2046-2052. DOI: 10.1161/CIRCULATIONAHA.109.879783.
[11] 刘轶凡, 董智慧, 姜宝红, 等. 急性主动脉综合征研究进展[J]. 中华外科杂志, 2018, 56(12): 957-960. DOI: 10.3760/cma.j.issn.0529-5815.2018.12.019.
[12] SOLOW E B, VONGPATANASIN W, SKAUG B, et al. Antinuclear antibodies are associated with all-cause mortality and cardiovascular outcomes in the general population[J]. J Am Coll Cardiol, 2015, 65(24): 2669-2670. DOI: 10.1016/j.jacc.2015.03.578.
[13] NATORSKA J, CELIN 'SKA-LÖWENHOFF M, UNDAS A I. High prevalence of antinuclear antibodies in patients following venous thromboembolism[J]. Adv Clin Exp Med, 2018, 27(6): 827-832. DOI: 10.17219/acem/78361.
[14] KROEGER K, KREUZFELDER E. Humorale vaskulitisdiagnostik beiperipherer arterieller verschlusskrankheit[J]. Herz, 2004, 29(1): 26-31. DOI: 10.1007/s00059-004-2548-6.
[15] CHIMENTI M S, BALLANTI E, TRIGGIANESE P, et al. Vasculitides and the complement system: a comprehensive review[J]. Clin Rev Allergy Immunol, 2015, 49(3): 333-346. DOI: 10.1007/s12016-014-8453-8.
[16] KOZUN' M, KOBIELARZ M, CHWIŁKOWSKA A, et al. The impact of development of atherosclerosis on delamination resistance of the thoracic aortic wall[J]. J Mech Behav Biomed Mater, 2018, 79: 292-300. DOI: 10.1016/j.jmbbm.2018.01.009.
[17] SUWANCHOTE S, RACHAYON M, RODSAWARD P, et al. Anti-neutrophil cytoplasmic antibodies and their clinical significance[J]. Clin Rheumatol, 2018, 37(4): 875-884. DOI: 10.1007/s10067-018-4062-x.
[18] LI X Y, LIU X, CUI J J, et al. Epidemiological survey of antinuclear antibodies in healthy population and analysis of clinical characteristics of positive population[J]. J Clin Lab Anal, 2019, 33(8): e22965. DOI: 10.1002/jcla.22965.