Department of Cardiosurgery, Weifang Traditional Chinese Hospital, Weifang, Shandong Province, China.
Department of Central Laboratory, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China.
J Int Med Res. 2021 Mar;49(3):3000605211002379. doi: 10.1177/03000605211002379.
To determine if plasma exosomal microRNAs (miRNAs) can predict survival in patients with idiopathic pulmonary arterial hypertension (IPAH).
The study enrolled patients with IPAH that underwent right heart catheterization. Plasma was collected and exosomal miRNAs were extracted. Exosomes were evaluated using transmission electron microscopy, Western blot analysis and particle size distribution analysis. MiRNAs were evaluated using a miRNA microarray and validated using real-time polymerase chain reaction.
This study included 12 patients with IPAH in the study group and 48 patients with IPAH in the validation group. The mean ± SD follow-up duration was 60.3 ± 35.4 months in the overall cohort. The levels of miR-596 were higher in the nonsurvivors compared with the survivors. The levels of miR-596 significantly correlated with survival time, mean right atrial pressure, pulmonary vascular resistance (PVR) and cardiac index. High levels of miR-596 and PVR were significantly associated with poor overall survival. Multivariate analysis demonstrated that exosomal miR-596 (hazard ratio [HR] = 2.119; 95% confidence interval [CI] 1.402, 3.203) and PVR (HR = 1.146; 95% CI 1.010, 1.300) were independent predictors of survival.
High levels of plasma exosomal miR-596 were significantly associated with disease severity and poor prognosis of patients with IPAH.
确定血浆外泌体 microRNAs（miRNAs）是否可预测特发性肺动脉高压（IPAH）患者的生存情况。
该研究纳入了接受右心导管检查的 IPAH 患者。采集血浆并提取外泌体 miRNA。使用透射电子显微镜、Western blot 分析和颗粒大小分布分析评估外泌体。使用 miRNA 微阵列评估 miRNA，并使用实时聚合酶链反应进行验证。
本研究包括研究组中的 12 例 IPAH 患者和验证组中的 48 例 IPAH 患者。总队列的平均随访时间为 60.3±35.4 个月。与幸存者相比，非幸存者的 miR-596 水平更高。miR-596 水平与生存时间、平均右心房压、肺血管阻力（PVR）和心指数显著相关。miR-596 水平高和 PVR 高与总体生存率差显著相关。多变量分析表明，外泌体 miR-596（风险比 [HR] = 2.119；95%置信区间 [CI] 1.402, 3.203）和 PVR（HR = 1.146；95% CI 1.010, 1.300）是生存的独立预测因子。
血浆外泌体 miR-596 水平高与 IPAH 患者的疾病严重程度和预后不良显著相关。
