CC BY 4.0 · Aorta (Stamford) 2021; 09(04): 127-138
DOI: 10.1055/s-0041-1730295
State-of-the-Art Review

Initiating a New Era of Cardiovascular Diagnosis and Therapy in Acute Aortic Syndromes: The Mainz–Essen Experience (Part I)—Imaging and Biomarkers

Eduardo Bossone*
1   Division of Cardiology, A. Cardarelli Hospital, Naples, Italy
Riccardo Gorla*
2   Division of Cardiology, Scientific Institute for Research, Hospitalization and Healthcare Policlinico San Donato, San Donato Milanese, Milan, Italy
3   Department of Imaging, Scientific Institute for Research, Hospitalization and Healthcare SDN, Naples, Italy
4   Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy
Heinz Jakob
5   Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
Raimund Erbel
6   Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), University of Duisburg-Essen, University Hospital Essen, Essen, Germany
› Author Affiliations
Funding None.


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.

* Equally contributed.

Supplementary Material

Publication History

Received: 05 June 2020

Accepted: 25 February 2021

Article published online:
08 November 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (

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