Department of Cardiovascular Surgery, Liaocheng People's Hospital, Liaocheng 252000, China.
Hellenic J Cardiol. 2020 Jan-Feb;61(1):26-30. doi: 10.1016/j.hjc.2018.06.004. Epub 2018 Jun 8.
Most pulmonary arterial hypertension (PAH) biomarkers are used for risk stratification and prognosis prediction. We aimed to evaluate the diagnostic value of circulating serum miR-509-3p in PAH with congenital heart disease.
Preoperative blood samples were collected from patients who were diagnosed as having PAH and had to receive right ventricular catheterization. According to right ventricular catheterization results, these patients were divided into a control group with normal mean pulmonary artery pressure (mPAP < 20 mmHg) and a PAH group (mPAP ≥ 25 mmHg). The expression of serum miR-509-3p was detected by real-time quantitative PCR. The receiver operating characteristic curve was plotted. A dichotomous logistic regression model was also established.
The expression level of circulating serum miR-509-3p in the PAH group was significantly lower than that of the control group. Based on the relative expression of miR-509-3p in serum, the area under the curve (AUC) for single-factor diagnosis of PAH was 0.694 (95% confidence interval [CI]: 0.555-0.883, P = 0.01), which was approximately 0.81 (AUC of noninvasive screening by echocardiography). When the relative expression of miR-509-3p was 0.79, the sensitivity and specificity were 80% and 60%, respectively. Based on the established model, AUC of serum miR-509-3p combined with echocardiography was 0.844, thus indicating a high diagnostic value. Compared with two individual indices, the combination further enhanced the diagnostic efficiency.
The expression of miR-509-3p decreased in the serum of patients with PAH along with congenital heart disease. The diagnostic value of circulating serum miR-509-3p in PAH was close to that obtained by echocardiography. Combining the two indices further increased the diagnostic efficiency of PAH.
大多数肺动脉高压（PAH）生物标志物用于风险分层和预后预测。本研究旨在评估循环血清 miR-509-3p 在先天性心脏病合并 PAH 中的诊断价值。
收集术前经右心导管检查诊断为 PAH 且必须接受右心导管检查的患者的血液样本。根据右心导管检查结果，将这些患者分为对照组（平均肺动脉压（mPAP）<20mmHg）和 PAH 组（mPAP≥25mmHg）。采用实时定量 PCR 检测血清 miR-509-3p 的表达。绘制受试者工作特征曲线。还建立了二项逻辑回归模型。
PAH 组循环血清 miR-509-3p 的表达水平明显低于对照组。基于血清中 miR-509-3p 的相对表达，PAH 的单因素诊断曲线下面积（AUC）为 0.694（95%置信区间[CI]：0.555-0.883，P=0.01），接近超声心动图无创筛查的 0.81（AUC）。当 miR-509-3p 的相对表达为 0.79 时，敏感性和特异性分别为 80%和 60%。基于建立的模型，血清 miR-509-3p 与超声心动图联合的 AUC 为 0.844，表明具有较高的诊断价值。与两个单独的指标相比，联合进一步提高了诊断效率。
先天性心脏病合并 PAH 患者血清中 miR-509-3p 的表达降低。循环血清 miR-509-3p 在 PAH 中的诊断价值与超声心动图相当。联合这两个指标进一步提高了 PAH 的诊断效率。
