Circulating levels of miR-133a predict the regression potential of left ventricular hypertrophy after valve replacement surgery in patients with aortic stenosis.

[wolf-hirschhorn syndrome]

Myocardial microRNA-133 a (miR-133 a ) is directly related to reverse remodeling after pressure overload release in aortic stenosis patients . Herein , we assessed the significance of plasma miR-133 a as an accessible biomarker with prognostic value in predicting the reversibility potential of LV hypertrophy after aortic valve replacement (AVR ) in these patients .The expressions of miR-133 a and its targets were measured in LV biopsies from 74 aortic stenosis patients . Circulating miR-133 a was measured in peripheral and coronary sinus blood . LV mass reduction was determined echocardiographically . Myocardial and plasma levels of miR-133 a correlated directly (r =0 .46 , P <0 .001 ) supporting the myocardium as a relevant source of plasma miR-133 a . Accordingly , a significant gradient of miR-133 a was found between coronary and systemic venous blood . The preoperative plasma level of miR-133 a was higher in the patients who normalized LV mass 1 year after AVR than in those exhibiting residual hypertrophy . Logistic regression analysis identified plasma miR-133 a as a positive predictor of the hypertrophy reversibility after surgery . The discrimination of the model yielded an area under the receiver operator characteristic curve of 0 .89 (P <0 .001 ). Multiple linear regression analysis revealed plasma miR-133 a and its myocardial target Wolf-Hirschhorn syndrome candidate 2 /Negative elongation factor A as opposite predictors of the LV mass loss (g ) after AVR .Preoperative plasma levels of miR-133 a reflect their myocardial expression and predict the regression potential of LV hypertrophy after AVR . The value of this bedside information for the surgical timing , particularly in asymptomatic aortic stenosis patients , deserves confirmation in further clinical studies .

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wolf-hirschhorn syndrome

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