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A new predictive marker of ventricular remodeling associated with aortic stenosis
Um novo marcador preditivo da remodelagem ventricular associado a estenose aórtica
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"itemAnterior" => array:20 [ "pii" => "S2174204920302932" "issn" => "21742049" "doi" => "10.1016/j.repce.2020.11.009" "estado" => "S300" "fechaPublicacion" => "2020-07-01" "aid" => "1559" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Rev Port Cardiol. 2020;39:377-87" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "MicroRNAs and ventricular remodeling in aortic stenosis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "377" "paginaFinal" => "387" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "MicroRNAs e remodelagem ventricular na estenose aórtica" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 3978 "Ancho" => 3008 "Tamanyo" => 341116 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Correlations between miR-125b-5p expression and echocardiographic variables and biomarkers. Spearman's rank correlation was used. ΔLVM: left ventricular mass variation; ANP: atrial natriuretic peptide; LVMI0: left ventricular mass index at baseline; LVMIf: left ventricular mass index at six-month follow-up; RWTf: relative wall thickness at six-month follow-up. MiR-125b-5p was negatively correlated with (b) RWT (rs=-0.633, p=0.036, n=11), (c) LVMIf (rs=-0.610, p=0.046, n=11), (e) ANP (rs=-0.786, p=0.036, n=7) and (f) BNP (rs=-0.767, p=0.016, n=9).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "João Santos-Faria, Cristina Gavina, Patrícia Rodrigues, João Coelho, Paula da Costa Martins, Adelino Leite-Moreira, Inês Falcão-Pires" "autores" => array:7 [ 0 => array:2 [ "nombre" => "João" "apellidos" => "Santos-Faria" ] 1 => array:2 [ "nombre" => "Cristina" "apellidos" => "Gavina" ] 2 => array:2 [ "nombre" => "Patrícia" "apellidos" => "Rodrigues" ] 3 => array:2 [ "nombre" => "João" "apellidos" => "Coelho" ] 4 => array:2 [ "nombre" => "Paula" "apellidos" => "da Costa Martins" ] 5 => array:2 [ "nombre" => "Adelino" "apellidos" => "Leite-Moreira" ] 6 => array:2 [ "nombre" => "Inês" "apellidos" => "Falcão-Pires" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0870255120302675" "doi" => "10.1016/j.repc.2019.09.014" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255120302675?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204920302932?idApp=UINPBA00004E" "url" => "/21742049/0000003900000007/v1_202012131838/S2174204920302932/v1_202012131838/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>" "titulo" => "A new predictive marker of ventricular remodeling associated with aortic stenosis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "389" "paginaFinal" => "390" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Henrique Girão" "autores" => array:1 [ 0 => array:4 [ "nombre" => "Henrique" "apellidos" => "Girão" "email" => array:1 [ 0 => "hmgirao@fmed.uc.pt" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Clinical Academic Centre of Coimbra, CACC, Coimbra, Portugal" "etiqueta" => "c" "identificador" => "aff0015" ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Um novo marcador preditivo da remodelagem ventricular associado a estenose aórtica" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In their paper on microRNAs (miRs) and ventricular remodeling in aortic stenosis (AS) published in this issue of the <span class="elsevierStyleItalic">Journal</span>,<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> which studied circulating biomarkers of extracellular matrix (ECM) turnover from myocardial biopsies, Santos-Faria et al. investigated the association between left ventricular (LV) miR levels and LV mass, reverse remodeling and ECM alterations.</p><p id="par0010" class="elsevierStylePara elsevierViewall">AS, in which the aortic valve progressively narrows, causes LV pressure overload that, in its early asymptomatic stages, triggers a compensatory hypertrophic response aimed at maintaining cardiac muscle performance. However, over the course of time, as a consequence of cardiomyocyte death and myocardial fibrosis, this process decompensates and patients progress to heart failure, which is associated with substantial morbidity and mortality.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> AS should thus be considered a disease of both the valve and the myocardium.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> Assessment of the pathophysiological effects on the myocardium associated with AS relies mainly on histological assays of heart samples. Small biopsy or autopsy studies have demonstrated that, besides cardiomyocyte hypertrophy, LV remodeling also encompasses changes in ECM proteins, in which the matrix structure is degraded and disrupted.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> This is regulated by various factors, including the renin-angiotensin-aldosterone system (RAAS), transforming growth factor beta, apoptosis signal-regulating kinase 1, and tissue inhibitor of metalloproteinase.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> However, in vivo studies using biopsies are limited and demanding given the small size of the samples, and fibrosis is assessed based on the quantity of collagen deposition, reflected in collagen volume fraction.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Patient symptoms and outcome in AS are determined by the severity of valve stenosis. Despite progress in recent years, no therapies are available to prevent worsening of the disease. The only treatment at the clinician's disposal for severe AS with LV decompensation is aortic valve replacement (AVR). A recent study showed that surgical AVR improved the physical and mental health status of octogenarians with severe AS. This improvement was evident at three months and consistent at six and 12 months.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">It is therefore of the utmost importance to identify markers of early LV decompensation in order to determine the correct timing for AVR, as well as features that can be used to track myocardial health over time, which will provide better knowledge of the mechanisms underlying LV decompensation in AS. Histological studies and noninvasive imaging techniques have been used as a prognostic tool by correlating myocardial fibrosis stage with AS and heart failure progress and severity. Identification of markers of ventricular remodeling in AS therefore has considerable clinical potential.</p><p id="par0025" class="elsevierStylePara elsevierViewall">MiRs are a class of small noncoding RNAs, about 22 nucleotides in length, that regulate post-transcriptional gene expression. It has been widely reported that miRs modulate various biological processes implicated in cardiovascular disorders including hypertrophy, ischemia, arrhythmias, pulmonary hypertension and valvular disease.<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">8–10</span></a> Importantly, several studies have associated miR profile with human diseases, making these molecules powerful diagnostic and prognostic tools. Changes in miR profile have been associated with myocardial fibrosis by targeting proteins involved in different aspects of ECM remodeling.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The study by Santos-Faria et al.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> shows that miR expression is different in cardiac biopsies obtained from AS and non-AS patients, which may have implications for ventricular remodeling responses to pressure overload before and after AVR. The authors show that miR-101-3p is increased in AS compared to controls, which is associated with higher plasma angiotensin II (Ang II) receptor and angiotensin-converting enzyme levels, ascribing to this miR a role in the regulation of the RAAS. Strikingly, a positive correlation with LV mass regression after surgery suggests that higher levels of miR-101-3p may be an indicator of a more favorable response to AVR. Moreover, although no statistically significant differences were found between AS patients and controls, miR-4268 levels in AS correlated positively with LV mass regression and were associated with higher plasma Ang II receptor levels. Given the antihypertrophic and antifibrotic properties of this receptor, it is conceivable that the Ang II receptor is involved in the regression of hypertrophy after surgery.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Overall, these results associate miR-101-3p and miR-4268 with a hypertrophic response in AS, making these miRs predictive markers of LV myocardial remodeling after AVR. Importantly, their role in regulating the RAAS paves the way toward the development of new pharmacological strategies targeting the RAAS.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "MicroRNAs and ventricular remodeling in aortic stenosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 4 | 8 |
| 2024 October | 49 | 30 | 79 |
| 2024 September | 49 | 28 | 77 |
| 2024 August | 76 | 42 | 118 |
| 2024 July | 38 | 37 | 75 |
| 2024 June | 26 | 32 | 58 |
| 2024 May | 25 | 14 | 39 |
| 2024 April | 26 | 23 | 49 |
| 2024 March | 24 | 25 | 49 |
| 2024 February | 27 | 27 | 54 |
| 2024 January | 29 | 22 | 51 |
| 2023 December | 26 | 27 | 53 |
| 2023 November | 38 | 33 | 71 |
| 2023 October | 20 | 14 | 34 |
| 2023 September | 21 | 20 | 41 |
| 2023 August | 18 | 15 | 33 |
| 2023 July | 17 | 7 | 24 |
| 2023 June | 17 | 9 | 26 |
| 2023 May | 33 | 35 | 68 |
| 2023 April | 12 | 10 | 22 |
| 2023 March | 26 | 21 | 47 |
| 2023 February | 24 | 21 | 45 |
| 2023 January | 13 | 14 | 27 |
| 2022 December | 28 | 24 | 52 |
| 2022 November | 30 | 30 | 60 |
| 2022 October | 22 | 25 | 47 |
| 2022 September | 21 | 36 | 57 |
| 2022 August | 18 | 29 | 47 |
| 2022 July | 17 | 36 | 53 |
| 2022 June | 22 | 34 | 56 |
| 2022 May | 22 | 17 | 39 |
| 2022 April | 28 | 27 | 55 |
| 2022 March | 29 | 57 | 86 |
| 2022 February | 25 | 43 | 68 |
| 2022 January | 25 | 31 | 56 |
| 2021 December | 16 | 34 | 50 |
| 2021 November | 21 | 26 | 47 |
| 2021 October | 39 | 44 | 83 |
| 2021 September | 17 | 29 | 46 |
| 2021 August | 19 | 32 | 51 |
| 2021 July | 16 | 18 | 34 |
| 2021 June | 22 | 33 | 55 |
| 2021 May | 29 | 51 | 80 |
| 2021 April | 46 | 49 | 95 |
| 2021 March | 28 | 15 | 43 |
| 2021 February | 18 | 12 | 30 |
| 2021 January | 26 | 20 | 46 |
| 2020 December | 30 | 10 | 40 |
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