Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, 20246 Hamburg, Germany.
Department of Cardiothoracic Surgery, Augsburg University Hospital, 86150 Augsburg, Germany.
Rev Cardiovasc Med. 2022 Feb 8;23(2):47. doi: 10.31083/j.rcm2302047.
The limitation of aortic size-based criteria is gradually recognized in the prediction of aortic events especially in bicuspid aortic valve (BAV) cohorts, while most aortic events happen in patients with proximal aortic diameters <50 mm. Circulating microRNAs (miRs) have been addressed as a novel tool to improve risk stratification in patients with different aortopathies. We aimed to elucidate the correlation between peripheral whole blood and aortic tissue miRs in order to prove the potential availability as a biomarker in the clinical routine.
All patients who received elective aortic valve repair/replacement ± proximal aortic replacement to BAV disease (n = 65, 2013-2018) were prospectively included. The expression of 10 miRs (miR-1, miR-17, miR-18a, miR-19a, miR-20a, miR-21, miR-106a, miR-133a, miR-143 and miR-145) was analyzed in the intraoperatively acquired aortic tissue as well as in the peripheral blood before the surgery.
We found a significant correlation between circulating miRs in the peripheral blood and aortic tissue levels of miR-21 (r = 0.293, = 0.02), miR-133a (r = 0.43, = 0.02), miR-143 (r = 0.68, 0.001), and miR-145 (r = 0.68, 0.001). Further, the multivariate logistic regression analysis revealed an association between blood and aortic tissue miR-143 levels each other (Odds Ratio [OR] 1.29, 95% Confidence Interval [CI] 1.11-1.67, = 0.02; OR 1.36, 95% CI 1.19-2.01, = 0.03, respectively) and a blood/aortic miR-143 level to dilated aorta (OR 3.61, 95% CI 1.62-9.02, = 0.01; OR 2.92, 95% CI 1.81-7.05, = 0.02, respectively).
Our study demonstrates a significant correlation between peripheral whole blood and aortic tissue miRs, confirming the hypothesis that circulating miRs may reflect remodeling processes in the proximal aorta in bicuspid aortopathy patients.
基于主动脉大小的标准的局限性在主动脉事件的预测中逐渐被认识到，特别是在二叶式主动脉瓣（BAV）患者中，而大多数主动脉事件发生在主动脉近端直径<50mm 的患者中。循环 microRNAs（miRs）已被用作改善不同主动脉病变患者风险分层的新工具。我们旨在阐明外周全血和主动脉组织 miRs 之间的相关性，以证明其作为临床常规生物标志物的潜在可用性。
前瞻性纳入 2013-2018 年因 BAV 疾病接受择期主动脉瓣修复/置换±近端主动脉置换的所有患者（n=65，2013-2018 年）。分析术中获得的主动脉组织以及术前外周血中 10 种 miRs（miR-1、miR-17、miR-18a、miR-19a、miR-20a、miR-21、miR-106a、miR-133a、miR-143 和 miR-145）的表达情况。
我们发现外周血循环 miR 与主动脉组织 miR-21（r=0.293， = 0.02）、miR-133a（r=0.43， = 0.02）、miR-143（r=0.68， 0.001）和 miR-145（r=0.68， 0.001）水平之间存在显著相关性。进一步的多变量逻辑回归分析显示，血液和主动脉组织 miR-143 水平之间存在相关性（优势比[OR]1.29，95%置信区间[CI]1.11-1.67， = 0.02；OR 1.36，95%CI 1.19-2.01， = 0.03），并且血液/主动脉 miR-143 水平与扩张的主动脉之间存在相关性（OR 3.61，95%CI 1.62-9.02， = 0.01；OR 2.92，95%CI 1.81-7.05， = 0.02）。
本研究表明外周全血和主动脉组织 miRs 之间存在显著相关性，证实了循环 miRs 可能反映二叶式主动脉瓣病变患者近端主动脉重塑过程的假设。
