心律失常性右心室心肌病合并室性心律失常患者循环microRNAs的表达
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Circulating microRNAs in arrhythmogenic right ventricular cardiomyopathy with ventricular arrhythmia
背景与目的
microRNAs(MiRNAs)与心脏疾病密切相关。本研究旨在研究心律失常性右心室心肌病(ARVC)患者循环中的miRNAs的特点，并将其与ARVC的临床结局联系起来。
方 法
本研究共纳入62例室性心律失常患者（VA）：28例（45%）明确诊断为ARVC，11例（18%）为疑似ARVC，23例（37%）诊断为特发性室性心动过速（VT）。此外，33名年龄和性别匹配的健康受试者作为正常对照。对所有研究对象的miRNAs的表达进行分析。对导管消融后诊断明确的ARVC患者的临床疗效进行了进一步的探讨。在miRNA聚合酶链式反应阵列的基础上，我们选择了11种miRNAs，对其在所有受试者血浆中的表达进行了分析。
结 果
明确诊断的ARVC患者循环miR-144-3p、145-5p、185-5p和494的表达明显高于其他三组。在25例经导管射频消融术的ARVC患者中，8例(32%)在后续时间(45±20个月)复发。明确诊断为ARVC合并复发性VA 的患者循环miR-494水平高于无复发的患者。对受试者工作特征曲线分析显示，miR-494是复发性VA的预测因子（曲线下面积：0.832）。
结 论
明确诊断的ARVC合并VA患者血浆miR-144-3p、145-5p、185-5p和494水平明显升高。血浆中miR-494水平的升高与明确诊断的ARVC患者行导管消融后VA的复发有关。
原始文献摘要
Shinya Yamada, Ya-Wen Hsiao, Shih-Lin Chang，et al . Circulating microRNAs in arrhythmogenic right ventricular cardiomyopathy with ventricular arrhythmia. Europace 2018 Jun 01 ;20(FI1) DOI：10.1093/europace/eux289
Aims MicroRNAs (miRNAs) have been implicated in cardiac diseases. This study aimed to characterize the circulating miRNAs in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) and correlate the miRNAs with the clinical outcomes of ARVC.
Methods and result This study included 62 patients with ventricular arrhythmia (VA): 28 patients (45%) had definite ARVC, 11 (18%) had borderline or possible ARVC, and 23 (37%) had idiopathic ventricular tachycardia (VT). In addition, 33 ageand sex-matched healthy subjects were enrolled as normal control subjects. The expression of selected miRNAs was analysed in all study subjects. The clinical outcomes of patients with definite ARVC after catheter ablation were further investigated. On the basis of the miRNA polymerase chain reaction array, we selected 11 miRNAs for analysis of their expression in the plasma of all subjects. Definite ARVC patients had significantly higher expression of circulating miR-144-3p, 145-5p, 185-5p, and 494 than the three other groups. Out of 25 definite ARVC patients who underwent radiofrequency catheter ablation, recurrent VA occurred in 8 patients (32%) during the follow-up period (45 ± 20 months). Definite ARVC patients with recurrent VA had a higher level of circulating miR-494 than did those without recurrence. Receiver operating characteristic analysis showed miR-494 to be a predictive factor of recurrent VA (area under the curve: 0.832).
Conclusion Plasma levels of miR-144-3p, 145-5p, 185-5p, and 494 were significantly elevated in definite ARVC patients with VA. An increased plasma level of miR-494 was associated with the recurrence of VA after ablation in definite ARVC patients.
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