血清 miR-106 和 MYL4 水平与心房颤动的患病率、危险分层和预后的关系。
Relationship between Serum miR-106 and MYL4 Levels and the Prevalence, Risk Stratification, and Prognosis of Atrial Fibrillation.
机构信息
Department of Internal Medicine-Cardiovascular, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang 330000, Jiangxi Province, China.
出版信息
J Immunol Res. 2022 Jul 14;2022:1069866. doi: 10.1155/2022/1069866. eCollection 2022.
OBJECTIVE
To analyze the predictive value of serum microRNA-106 (miRNA-106), miR-106, and myosin light chain 4 (MYL4) levels on the prevalence of atrial fibrillation and to explore the relationship between serum miR-106 and MYL4 and the risk stratification and prognosis of atrial fibrillation, thereby providing basis for them to become clinical targets for the treatment of atrial fibrillation in the future.
METHODS
300 patients with atrial fibrillation treated in our hospital from May 2017 to March 2019 were selected as the atrial fibrillation group, and 300 healthy people who came to our hospital for physical examination in the same period were selected as the control group. The general data of the subjects in the two groups were collected. The serum miR-106 level of the subjects in the two groups was detected by fluorescence quantitative polymerase chain reaction (PCR), and the level of MYL4 was detected by enzyme-linked immunosorbent assay (ELISA). The expression of miR-106 and MYL4 in the myocardium was observed by immunohistochemistry. The relationship between the levels of serum miR-106 and MYL4 and the prevalence of atrial fibrillation and the score of atrial fibrillation thromboembolism risk stratification scoring system (cha2ds2) was compared between the two groups. The relationship between serum level of miR-106 and prognosis of patients with atrial fibrillation was analyzed.
RESULTS
The systolic blood pressure, diastolic blood pressure, total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and left anterior descending artery (LAD) in the atrial fibrillation group were significantly higher than those in the control group, while HDL-C and left ventricular ejection fraction (LVEF) were significantly lower than those in the control group ( < 0.01). The level of serum miR-106 in patients with atrial fibrillation was significantly higher than that in the control group, whereas the level of MYL4 was significantly lower than that in the control group ( < 0.01). miR-106 was mainly localized in the cytoplasm, and the positive expression rate of miR-106 was 71.43% (81/115) in patients with atrial fibrillation and 21.74% (25/115) in patients with sinus rhythm. MYL4 was mainly located in the cell membrane and the positive expression rate of MYL4 was 24.35% (28/115) in patients with atrial fibrillation and 64.35% (74/115) in patients with sinus rhythm. With the increase of the severity of atrial fibrillation, the level of serum miR-106 gradually increased and the level of MYL4 gradually decreased, which were statistically significant compared with the control group ( < 0.05). With the increase of miR-106 level and the decrease of MYL4 level, the prevalence of atrial fibrillation gradually increased. With the increase of cha2ds2 score, the level of serum miR-106 increased and the level of MYL4 decreased. The survival rate of patients with miR - 106 ≤ 1.96 was significantly higher than that of patients with miR - 106 > 1.96. The survival rate of patients with MYL4 ≥ 0.24 was significantly higher than that of patients with MYL4 < 0.24. At the same time, TC and LDL-C were included in the analysis. The results showed that the survival rate of patients with TC ≤ 4.5 mmol/L was significantly higher than that of patients with TC > 4.5 mmol/L, and that of patients with LDL-C ≤ 2.6 mmol/L was significantly higher than that of patients with LDL-C > 2.6 mmol/L.
CONCLUSION
Serum miR-106 and MYL4 levels are closely related to the prevalence of atrial fibrillation, which can reflect the risk of thromboembolism in patients with atrial fibrillation and can be used as a biological indicator to predict the prognosis of patients with atrial fibrillation.
目的
分析血清微小 RNA-106(miRNA-106)、miR-106 和肌球蛋白轻链 4(MYL4)水平对心房颤动发生率的预测价值,并探讨血清 miR-106 和 MYL4 与心房颤动风险分层和预后的关系,为其成为未来心房颤动治疗的临床靶点提供依据。
方法
选取 2017 年 5 月至 2019 年 3 月在我院治疗的 300 例心房颤动患者为房颤组,同期选取 300 名在我院体检的健康人为对照组。收集两组受试者的一般资料,采用荧光定量聚合酶链反应(PCR)检测两组受试者血清 miR-106 水平,酶联免疫吸附试验(ELISA)检测 MYL4 水平,免疫组化观察心肌组织中 miR-106 和 MYL4 的表达。比较两组血清 miR-106 和 MYL4 水平与心房颤动发生率及心房颤动血栓栓塞风险分层评分系统(CHA2DS2-VASc)评分的关系,分析血清 miR-106 水平与心房颤动患者预后的关系。
结果
心房颤动组的收缩压、舒张压、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和左前降支(LAD)均明显高于对照组,而高密度脂蛋白胆固醇(HDL-C)和左心室射血分数(LVEF)明显低于对照组(<0.01)。心房颤动组患者血清 miR-106 水平明显高于对照组,而 MYL4 水平明显低于对照组(<0.01)。miR-106 主要定位于细胞质,心房颤动患者 miR-106 阳性表达率为 71.43%(81/115),窦性心律患者 miR-106 阳性表达率为 21.74%(25/115)。MYL4 主要定位于细胞膜,心房颤动患者 MYL4 阳性表达率为 24.35%(28/115),窦性心律患者 MYL4 阳性表达率为 64.35%(74/115)。随着心房颤动严重程度的增加,血清 miR-106 水平逐渐升高,MYL4 水平逐渐降低,与对照组比较差异均有统计学意义(<0.05)。随着 miR-106 水平的升高和 MYL4 水平的降低,心房颤动的发生率逐渐增加。随着 cha2ds2 评分的增加,血清 miR-106 水平升高,MYL4 水平降低。miR-106≤1.96 患者的生存率明显高于 miR-106>1.96 患者。MYL4≥0.24 患者的生存率明显高于 MYL4<0.24 患者。同时纳入 TC 和 LDL-C 进行分析,结果显示 TC≤4.5 mmol/L 患者的生存率明显高于 TC>4.5 mmol/L 患者,LDL-C≤2.6 mmol/L 患者的生存率明显高于 LDL-C>2.6 mmol/L 患者。
结论
血清 miR-106 和 MYL4 水平与心房颤动的发生率密切相关,能反映心房颤动患者的血栓栓塞风险,可作为预测心房颤动患者预后的生物学指标。