Szemraj-Rogucka Zofia M, Szemraj Janusz, Masiarek Konrad, Majos Agata
Department of Radiology and Diagnostic Imaging, Medical University of Lodz, Central Clinical Hospital, Lodz, Poland.
Department of Medical Biochemistry, Medical University of Lodz, Lodz, Poland.
Arch Med Sci. 2019 Mar;15(2):376-384. doi: 10.5114/aoms.2019.82919. Epub 2019 Mar 4.
Despite the fact that cardiovascular magnetic resonance (CMR) with late gadolinium enhancement (LGE) is a proven method for detecting myocardial fibrosis, there is a need for new and reliable serological biomarkers. Circulating miRNAs could be a practical and attractive alternative. The purpose of the study was to assess the miRNAs well established in myocardial fibrosis - miR-21, miR-29a, miR-30d and miR-133a - in the plasma of patients with left ventricular non-compaction (LVNC) that have areas of LGE assessed by CMR.
We prospectively enrolled 13 adult patients (9 males and 4 females; mean age: 39 ±11.7 years) considered to meet standard CMR criteria for LVNC and 10 healthy age- and sex-matched subjects. All LVNC patients and control subjects underwent CMR examination and the measurement of peripheral plasma levels of 4 miRNAs: miR-21, miR-29a, miR-30d and miR-133a.
The LGE was present in 9 of the 13 (69.2%) LVNC patients, and most often located in the ventricular septum. Compared with LGE-negative patients, LGE-positive patients had significantly lower LVEF (28.3 ±13.3% vs. 53.5 ±14.9%, = 0.0113) and greater LV end-diastolic diameter (67.8 ±9.5 mm vs. 57 ±2.2 mm, = 0.01). Significant up-regulation of all 4 miRNAs was observed among LGE-positive patients vs. LGE-negative patients: miR-21 ( = 0.007), miR-29a ( = 0.0001), miR-30d ( = 0.001) and miR-133a ( = 0.0003).
The up-regulation of miR-21, miR-29a, miR-30d and miR-133a indicates the presence of LGE in LVNC patients, and therefore they may serve as potential biomarkers for myocardial fibrosis.
尽管采用钆延迟增强（LGE）的心血管磁共振（CMR）是检测心肌纤维化的一种成熟方法，但仍需要新的可靠血清生物标志物。循环微小RNA（miRNA）可能是一种实用且有吸引力的替代物。本研究的目的是评估在心肌纤维化中已得到充分证实的miRNA——miR-21、miR-29a、miR-30d和miR-133a——在经CMR评估有LGE区域的左心室心肌致密化不全（LVNC）患者血浆中的情况。
我们前瞻性纳入了13例成年患者（9例男性和4例女性；平均年龄：39±11.7岁），这些患者被认为符合LVNC的标准CMR标准，以及10例年龄和性别匹配的健康受试者。所有LVNC患者和对照受试者均接受了CMR检查，并测量了外周血中4种miRNA（miR-21、miR-29a、miR-30d和miR-133a）的水平。
13例LVNC患者中有9例（69.2%）存在LGE，最常见于室间隔。与LGE阴性患者相比，LGE阳性患者的左心室射血分数（LVEF）显著降低（28.3±13.3%对53.5±14.9%，P = 0.0113），左心室舒张末期直径更大（67.8±9.5mm对57±2.2mm，P = 0.01）。与LGE阴性患者相比，LGE阳性患者中所有4种miRNA均显著上调：miR-21（P = 0.007）、miR-29a（P = 0.0001）、miR-30d（P = 0.001）和miR-133a（P = 0.0003）。
miR-21、miR-29a、miR-30d和miR-133a的上调表明LVNC患者存在LGE，因此它们可能作为心肌纤维化的潜在生物标志物。
