MicroRNAs distribution in different phenotypes of Aortic Stenosis

Abstract

Aortic valve stenosis (AVS) represents a cluster of different phenotypes, considering gradient and flow pattern. Circulating micro RNAs may reflect specific pathophysiological processes and could be useful biomarkers to identify disease. We assessed 80 patients (81, 76.7–84 years; 46, 57.5%females) with severe AVS. We performed bio-humoral evaluation (including circulating miRNA-1, 21, 29, 133) and 2D-echocardiography. Patients were classified according to ACC/AHA groups (D1-D3) and flow-gradient classification, considering normal/low flow, (NF/LF) and normal/high gradient, (NG/HG). Patients with reduced ejection fractionwere characterized by higher levels of miRNA1 (p = 0.003) and miRNA 133 (p = 0.03). LF condition was associated with higher levels of miRNA1 (p = 0.02) and miRNA21 (p = 0.02). Levels of miRNA21 were increased in patients with reduced Global longitudinal strain (p = 0.03). LF-HG and LF-LG showed higher levels of miRNA1 expression (p = 0.005). At one-year follow-up miRNA21 and miRNA29 levels resulted significant independent predictors of reverse remodeling and systolic function increase, respectively. Different phenotypes of AVS may express differential levels and types of miRNAs, which may retain a pathophysiological role in pro-hypertrophic and pro-fibrotic processes.

Serum Biomarkers of Cardiovascular Remodelling Reflect Extra-Valvular Cardiac Damage in Patients with Severe Aortic Stenosis

“…This is in contrast to our initial hypothesis, in which we expected significant differences for several biomarkers, at least in the LGAS group, when compared to HGAS or PLFLGAS. Thus, in contrast to our findings, Fabiani and colleagues could describe differences between different entities of aortic stenosis, at least with respect to pro-fibrotic microRNAs [38]. Similar studies focussing on surrogate biomarkers of cECM remodelling were not available from the literature until now.…”

Sex-specific microRNAs in women with diabetes and left ventricular diastolic dysfunction or HFpEF associate with microvascular injury

“…This dichotomous outcome in plasma miR-34a levels could indicate different pathophysiological mechanisms of plasma miR release in different phenotypes of diastolic dysfunction. This was previously demonstrated with plasma miRs following different stages of cardiomyocyte remodeling in patients with aortic stenosis 18 . It could also indicate that different stages of diastolic dysfunction change the distribution of circulating miRs among plasma carriers like high density lipoprotein (HDL), extracellular vesicles and plasma Argonaute-2 protein, like we previously demonstrated following a phenotypic progression from DM to diabetic nephropathy 19 .…”

Growth Differentiation Factor 15 in Severe Aortic Valve Stenosis: Relationship with Left Ventricular Remodeling and Frailty

“…A translation of this information to the broad setting of risk evaluation in patients with AVS who are candidates for an intervention was logical. Here, the concept of risk stratification using biomarkers is appealing [8,17,29,30]. Recently, GDF15 has been shown to be superior to natriuretic peptides for predicting risk in patients undergoing TAVI, and has been shown to have incremental value over the logistic Euroscore, enabling a substantial reclassification of patients [9,31].…”