在接受过导管大动脉置换的患者中,microRNA-21表达的临床意义和相关性
Anat Berkovitch1, Zvi Sirotkin1, Yoni Grossman1
1Division of Cardiology, Leviev Cardiovascular & Thoracic Center, Chaim Sheba Medical Center, Tel Hashomer affiliated to School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
American journal of physiology. Heart and circulatory physiology
|August 26, 2025
概括
过导管大动脉置换 (TAVR) 后miR- 21水平显著下降表明主要心血管不良事件和死亡风险较高. 这一发现突出了miR-21作为TAVR患者结果的潜在生物标志物.
科学领域:
- 心脏病学
- 生物标志物发现
- 分子诊断
背景情况:
- 过导管的大动脉置换 (TAVR) 是严重的大动脉狭窄的常见手术.
- 在TAVR后心脏生物标志物升高是常见的,但其预后价值仍有争议.
- 微RNAs (miRNAs) 正在成为心血管疾病病原和潜在生物标志物的关键参与者.
研究的目的:
- 在接受TAVR的患者中研究特定miRNA的预后意义.
- 评估miRNAs对分层高风险患者的有用性.
- 在TAVR后将miRNA水平与主要心血管或脑血管不良事件 (MACCE) 相关联.
主要方法:
- 预期招募接受TAVR移植的患者.
- 在基线和TAVR后6小时采集血液样本.
- 使用PCR对miR-21,miR-1和miR-210进行量化,并通过ΔΔCt方法进行相对量化 (RQ).
- 分析MACCE作为主要结果和ROC曲线分析miRNA相关性.
主要成果:
- 分析了76名患者 (平均年龄为80. 8岁); MACCE发生在近四分之一的患者中.
- 在预测无MACCE (R=0. 61) 时,miR- 21 RQ的准确性是中等的.
- 与非显著变化相比,显著降低miR-21水平 (RQ< 0. 709) 与更高的MACCE率 (40%对16%) 和30天死亡率 (12%对0%) 相关.
结论:
- 在TAVR后6小时,miR-21水平显著下降与患者的不良结果有关.
- 在TAVR患者中,miR-21显示为风险分层的潜在生物标志物.
- 个性化TAVR后管理策略可能受益于miR-21监测.
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