MicroRNAs as potential biomarkers in congenital heart surgery

Abstract

General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/userguides/explore-bristol-research/ebr-terms/ MicroRNAs as potential biomarkers in congenital heart surgeryTelephone: 00441173423145 32 33 Word count: 3473 34 3 Glossary of Abbreviations 35 CPBcardio-pulmonary bypass 36 CHDcongenital heart disease 37 CHScongenital heart surgery 38 cTnscardiac troponins 39 ECMO -extracorporeal membrane oxygenation 40 ICUintensive care unit 41 ILOSintensive care length of stay 42 IQR -inter-quartile range; 43 miR-1 -microRNA-1 44 miRNA -microRNA 45 NHSnational health system 46 PICUpediatric intensive care unit 47 RACHS-1 -risk adjustment for CHS 48 SCEsevere cardiovascular event 49 VIventilation index 50 VISvasoactive-inotrope score 51 4Central picture legend 52 MicroRNAs could help predicting outcomes after pediatric congenital heart surgery. 53Central message 54 MiR-1 increases in plasma after pediatric cardiac surgery. It is associated with clinical scores 55 indicative of post-operative outcome and predicts intensive care stay and severe cardiovascular 56 events.57 5 Perspective statement 58 miR-1 is a potential biomarker of cardiac outcomes after pediatric cardiac surgery, a field where 59 accurate predictors are lacking. As opposed to the VIS and VI scores, changes in miR-1 appear 60 immediately after surgery and could signal cardiopulmonary bypass-associated complications. Abstract 62Objective: Pediatric congenital heart surgery (CHS) involves intra-cardiac, valvular and vascular 63 repairs. Accurate tools to aid short-term outcome prediction in pediatric CHS are lacking. Clinical 64 scores, such as the vasoactive-inotrope score (VIS) and ventilation index (VI), are used to define 65 outcome in clinical studies. MicroRNA-1-3p (miR-1) is expressed by both cardiomyocytes and 66 vascular cells and is regulated by hypoxia. In adult patients, miR-1 increases in the circulation 67 after open-heart cardiac surgery, suggesting its potential as a clinical biomarker. Thus, we 68 investigated whether perioperative circulating miR-1 measurements can help predict post-CHS 69 short-term outcomes in pediatric patients. 70Methods: Plasma miR-1 was retrospectively measured in a cohort of 199 consecutive pediatric 71 CHS patients (median age 1.2 years). Samples were taken before surgery and at the end of the 72 operation. Plasma miR-1 concentration was measured by RT-qPCR and expressed as miR-1 73 copies/µl and as relative expression to spiked-in exogenous cel-miR-39. 74Results: Baseline plasma miR-1 did not vary across different diagnoses, increased during surgery 75 (204-fold median relative increase, p<0.001) and was associated with aortic cross clamp duration 76 post-operatively (p<0.001). Importantly, miR-1 levels at the end of the operation positively 77 correlated with intensive care stay (p<0.001), early severe cardiovascular events (p=0.01), and 78 with high VIS (p=0...

The Year in Review: Anesthesia for Congenital Heart Disease 2019

“…In multivariate analysis, only age and cross-clamp time were associated with ICU LOS, VIS and, VI. 5 Kim-Campbell et al focused on the oxylipins 9hydroxyoctadecadienoic acid (9-HODE) and 13-HODE to predict outcomes. Both compounds are oxidation products of linoleic acid.…”

POSTTRANSCRIPTIONAL REGULATION IN CONGENITAL HEART DISEASE: THE ROLE OF miRNA

“…(2019), в которой установлено, что концентрация микроРНК-1 в плазме крови увеличивается в течение операции и в послеоперационном периоде. Кроме того, авторы отмечают изменение уровней микроРНК-1 в зависимости от тактики хирургической коррекции; так, установлена значимая ассоциация между содержанием микроРНК-1 в плазме и продолжительностью поперечного зажима аорты [50]. Как было сказано ранее, микроРНК-1 и ее ген-мишень, транскрипционный фактор HAND2, ответственны за дифференцировку кардиомиоцитов.…”

Developments in perioperative management: The yin to the yang of congenital heart surgery

“…[3][4][5] There has been a recent explosion of interest in applying our newfound knowledge of micro-RNAs in CHD. 6 This year, Stoica and colleagues 7 reported their findings in an attempt to discover a micro-RNA as a biomarker of cellular injury. In their study of 199 pediatric cardiac surgery patients, they demonstrate a dramatic postoperative increase in micro-RNA-1-3p (miR-1) from baseline, which was compounded by aortic crossclamp time and positively correlated with intensive care unit length of stay, postoperative occurrence of severe cardiac events, cardiovascular support (vasoactive-inotrope score), and ventilatory support (ventilation index).…”