冠心病患者循环血中MicroRNAs对心脏应激损伤的动力学研究
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Kinetics of Circulating MicroRNAs in Response to Cardiac Stress in Patients With Coronary Artery Disease
背景与目的：microRNA（miRNA / miR）在患有冠心病的患者循环血中受到调控。短暂冠状动脉缺血对循环血中miRNA的水平影响尚不清楚。我们的目的是研究在有或没有明显冠状动脉狭窄的患者循环血中响应心脏应激的miRNA动力学。
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方法：从105名稳定型冠心病患者中筛选80名患者，让其在冠状动脉造影前接受多巴酚丁胺负荷后行超声心动图检查。在多巴酚丁胺负荷超声心动图试验后立即和4小时，24小时后，通过逆转录聚合酶链反应，在血浆中定量9种循环血管miRNA（miRNA-21，miRNA-26，miRNA-27a，miRNA-92a，miRNA-126-3p，miRNA-133a，miRNA-222，miRNA-223和miRNA-199-5p）。
结果：定量聚合酶链反应显示所有患者在多巴酚丁胺负荷超声心动图后24小时miRNA-21，miRNA-126-3p和miRNA-222水平增加。在冠状动脉造影中，41例患者发现严重的冠状动脉狭窄（> 80％直径狭窄）。根据冠脉狭窄严重程度的患病率对患者进行分组，患有冠脉狭窄的患者显示出响应心脏应激的循环血中miRNA-21，miRNA-126-3p和miRNA-222的增加，在没有明显冠脉狭窄的患者中（＜50％直径狭窄），随着心脏的应激，循环血中miRNA-92a的水平逐渐升高。
结论：冠脉狭窄性应激损伤直接调控miRNAs释放入血。
Jansen F1, Schäfer L1, Wang H1, Schmitz T1, Flender A1, Schueler R1, Hammerstingl C1, Nickenig G1, Sinning JM1, Werner N2.
Kinetics of Circulating MicroRNAs in Response to Cardiac Stress in Patients With Coronary Artery Disease
J Am Heart Assoc. 2017;6:e005270. DOI: 10.1161/JAHA.116.005270.
BACKGROUND:Circulating microRNAs (miRNAs/miRs) are regulated in patients with coronary artery disease. The impact of transient coronary ischemia on circulating miRNA levels is unknown. We aimed to investigate circulating miRNA kinetics in response to cardiac stress in patients with or without significant coronary stenosis.
METHODS:Eighty of 105 screened patients with stable coronary artery disease underwent dobutamine stress echocardiography before coronary angiography. Nine circulating vascular miRNAs (miRNA-21, miRNA-26, miRNA-27a, miRNA-92a,miRNA-126-3p, miRNA-133a, miRNA-222, miRNA-223, and miRNA-199-5p) were quantified in plasma by reverse transcription polymerase chain reaction before, immediately after, and 4 and 24 hours after dobutamine stress echocardiography.
RESULTS:Quantitative polymerase chain reaction revealed increased miRNA-21, miRNA-126-3p, and miRNA-222 levels at 24 hours after dobutamine stress echocardiography in all patients. On coronary angiography, significant coronary artery stenoses (>80% diameter stenosis) were found in 41 patients. Stratifying patients according to the prevalence of significant stenoses, patients with stenosis showed an increase of circulating miRNA-21, miRNA-126-3p, and miRNA-222 in response to cardiac stress. In patients without significant stenoses (<50% diameter stenosis), miRNA-92a levels gradually increased in response to cardiac stress.
CONCLUSIONS:miRNAs are distinctly released into the circulation in response to cardiac stress depending on the prevalence of significant coronary stenoses.
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