Department of Cardiology, Beijing Chaoyang Hospital of Capital Medical University, Beijing, China; Department of Cardiology, Shijiazhuang People's Hospital, Shijiazhuang, China.
Department of Cardiology, Affiliated Hospital of Hebei University, Baoding, China.
Ann Palliat Med. 2021 Dec;10(12):12742-12749. doi: 10.21037/apm-21-3518.
Atrial fibrosis is a landmark of cardiac remodeling to perpetuate atrial fibrillation (AF), and recent studies have indicated that microRNAs (miRNAs) are essential regulators of multiple cardiovascular disease processes. Herein, we aimed to investigate the relationship between circulating microRNA-21 (miR-21), atrial fibrosis, and AF in patients with atrial enlargement.
A total of 60 persistent AF patients and 60 matched sinus rhythm (SR) controls were enrolled in the study. We measured their plasma miR-21 levels by using quantitative reverse transcription-polymerase chain reaction (qRT-PCR). Then, each patient underwent transthoracic echocardiography (TTE), while persistent AF patients underwent delayed enhancement magnetic resonance imaging (MRI).
The plasma miR-21 concentrations in the AF group were significantly higher than in the controls, and highly correlated [R=0.689, 95% confidence interval (CI): 0.527 to 0.802; P<0.001] with left atrial (LA) fibrosis measured by delayed enhancement MRI. Receiver operating characteristics (ROC) curve analysis showed that the area under the curve (AUC) of plasma miR-21 to identify AF was 0.813 (95% CI: 0.731 to 0.878). The increasing levels of circulating miR-21 were significantly associated with the higher risk of AF by using logistic regression analysis, even after adjustment for known confounding variables.
Circulating miR-21 highly correlates with the quantification of LA fibrosis by using delayed enhancement MRI and is associated with the risk of persistent AF in patients with LA enlargement.
心房纤维化是使心房颤动（房颤）持续存在的心脏重构的一个标志，最近的研究表明 microRNAs（miRNAs）是多种心血管疾病过程的重要调节因子。在此，我们旨在研究循环 microRNA-21（miR-21）、心房纤维化与心房扩大患者房颤之间的关系。
共纳入 60 例持续性房颤患者和 60 例窦性心律（SR）匹配对照者。我们使用定量逆转录聚合酶链反应（qRT-PCR）测量他们的血浆 miR-21 水平。然后，每位患者均接受经胸超声心动图（TTE）检查，而持续性房颤患者则接受延迟增强磁共振成像（MRI）检查。
房颤组的血浆 miR-21 浓度明显高于对照组，且与延迟增强 MRI 测量的左心房（LA）纤维化高度相关[R=0.689，95%置信区间（CI）：0.527 至 0.802；P<0.001]。受试者工作特征（ROC）曲线分析显示，血浆 miR-21 识别房颤的曲线下面积（AUC）为 0.813（95%CI：0.731 至 0.878）。逻辑回归分析显示，即使在校正了已知混杂变量后，循环 miR-21 水平的升高与房颤风险的增加显著相关。
循环 miR-21 与延迟增强 MRI 测量的 LA 纤维化程度高度相关，与 LA 扩大患者持续性房颤的风险相关。
