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Publication - Dr Giovanni Biglino

    MicroRNAs as potential biomarkers in congenital heart surgery


    Stoica, SC, Dorobantu, DM, Vardeu, A, Biglino, G, Ford, KL, Bruno, DV, Zakkar, M, Mumford, A, Angelini, GD, Caputo, M & Emanueli, C, 2019, ‘MicroRNAs as potential biomarkers in congenital heart surgery’. Journal of Thoracic and Cardiovascular Surgery.


    Objective: Pediatric congenital heart surgery (CHS)involves intracardiac, valvular, and vascular repairs. Accurate tools to aid short-term outcome prediction in pediatric CHS are lacking. Clinical scores, such as the vasoactive-inotrope score and ventilation index, are used to define outcome in clinical studies. MicroRNA-1-3p (miR-1)is expressed by both cardiomyocytes and vascular cells and is regulated by hypoxia. In adult patients, miR-1 increases in the circulation after open-heart cardiac surgery, suggesting its potential as a clinical biomarker. Thus, we investigated whether perioperative circulating miR-1 measurements can help predict post-CHS short-term outcomes in pediatric patients. 

    Methods: Plasma miR-1 was retrospectively measured in a cohort of 199 consecutive pediatric CHS patients (median age 1.2 years). Samples were taken before surgery and at the end of the operation. Plasma miR-1 concentration was measured by reverse transcription-quantitative polymerase chain reaction and expressed as miR-1 copies/μL and as relative expression to spiked-in exogenous cel-miR-39. 

    Results: Baseline plasma miR-1 did not vary across different diagnoses, increased during surgery (204-fold median relative increase, P <.001), and was associated with aortic crossclamp duration postoperatively (P <.001). Importantly, miR-1 levels at the end of the operation positively correlated with intensive care stay (P <.001), early severe cardiovascular events (P =.01), and with high vasoactive-inotrope score (P =.001)and ventilation index (P <.001), suggesting that miR-1 could accelerate the identification of patients with cardiopulmonary bypass−related ischemic complications, requiring more intensive support.

    Conclusions: Our study suggests miR-1 as a novel potential circulating biomarker to predict early postoperative outcome and inform clinical management in pediatric heart surgery.

    Full details in the University publications repository