Feldman Andre, Moreira Dalmo Antonio Ribeiro, Gun Carlos, Wang Hui-Tzu Lin, Hirata Mario Hiroyuki, de Freitas Germano Juliana, Leite Gabriela Guimarães Sousa, Farsky Pedro
Instituto Dante Pazzanese de Cardiologia Sao Paulo, São Paulo, BR.
School of Pharmaceutical Sciences, University of São Paulo São Paulo, São Paulo, BR.
Ann Hum Genet. 2017 May;81(3):99-105. doi: 10.1111/ahg.12188.
Atrial fibrillation (AF) is the most common arrhythmia after cardiac surgery. From a pathophysiological point of view, a myriad of factors such as trauma, atrial dilation, ischemia, mechanical myopericarditis, autonomic imbalance, loss of connexins, AF nest remodeling, inflammation, sutures, and dysfunction caused by postextracorporeal circulation can contribute to postoperative atrial fibrillation (POAF) resulting in a longer hospital stay and consequently higher cost. Recent studies showed that short fragments of RNA, called microRNA (miRNA), can contribute to the development of several cardiovascular diseases, including AF. The aim of this study was to evaluate the levels of circulating miRNAs (miR-1, -23a, and -26a) that can be involved in POAF. Patients submitted to coronary artery bypass graft surgery were grouped in POAF (24 patients) and without POAF (24 patients). Results showed older age, longer clamp-time, and more days in the intensive care unit as well as a longer total hospital stay in the POAF group. Preoperative levels of circulating miRNAs were similar. Analysis of miRNAs revealed significantly lower circulating levels of miRNA-23a (P = 0.02) and -26a (P = 0.01) in the POAF group during the postoperative period. Receiver operating characteristic (ROC) analysis showed the area under the ROC curve of miR-23a and miR-26a for predicting FA was 0.63 (95% confidence interval [CI]: 0.51-0.74; P = 0.02) and 0.66 (95% CI: 0.55-0.77; P = 0.01), respectively. Our data suggests that circulating miRNA-23a and -26a may be involved in the underlying biology of postoperative AF development.
心房颤动（AF）是心脏手术后最常见的心律失常。从病理生理学角度来看，创伤、心房扩张、缺血、机械性心肌心包炎、自主神经失衡、连接蛋白缺失、房颤巢重塑、炎症、缝线以及体外循环后引起的功能障碍等众多因素都可能导致术后房颤（POAF），从而延长住院时间并因此增加费用。最近的研究表明，短片段RNA，即微小RNA（miRNA），可能在包括房颤在内的几种心血管疾病的发生发展中起作用。本研究的目的是评估可能与POAF相关的循环miRNA（miR-1、-23a和-26a）水平。接受冠状动脉旁路移植术的患者被分为POAF组（24例患者）和非POAF组（24例患者）。结果显示，POAF组患者年龄更大、夹闭时间更长、在重症监护病房的天数更多，总住院时间也更长。术前循环miRNA水平相似。对miRNA的分析显示，POAF组术后miRNA-23a（P = 0.02）和-26a（P = 0.01）的循环水平显著降低。受试者工作特征（ROC）分析显示，miR-23a和miR-26a预测房颤的ROC曲线下面积分别为0.63（95%置信区间[CI]：0.51-0.74；P = 0.02）和0.66（95%CI：0.55-0.77；P = 0.01）。我们的数据表明，循环miRNA-23a和-26a可能参与了术后房颤发生发展的潜在生物学过程。
