| 【Background】Hypertension as a common cardiovascular disease,seriously affected the occurrence and development of cardiovascular and cerebrovascular diseases.Hypertensive heart disease refers to the long-term poor blood pressure caused by left ventricular hypertrophy and left ventricular diastolic dysfunction,and then progress into the heart failure of the disease.Hypertensive heart disease can change myocardium and lead to coronary blood vessels,the patient will appear high blood pressure for a long time,increased left ventricular load,left ventricular hypertrophy,expansion and other symptoms.Hypertensive left ventricular hypertrophy(HTN-LVH)is one of the characteristic manifestations of hypertensive heart disease.The development of left ventricular hypertrophy often leads to adverse outcomes such as heart failure and shock.Therefore,early detection and timely diagnosis and treatment are important in the prognosis of patients with hypertensive heart disease [1].Exosome is exocrined by the cell with a lipid bilayer structure of the diameter of about 30-100 nm microcapsules,basically all of the cells can secrete exosomes,which carry different conditions of the Protein、mRNA、miRNA and long chain non-coding RNA(lncRNA)and other substances.Studies have shown that they can mediate a certain distance from intercellular matter exchange.This exchange is based on intracellular genetic material(messenger RNA or microRNA)is wrapped into exosomes and released to the extracellular environment[2].The lipid bilayer structure of the exosomes can protect the contents from protease and nuclease degradation in the circulation [3].In recent years,researchers have explored the mechanism of autocrine and paracrine cytokines in order to find effective targets for reversing cardiac hypertrophy [2-4].MicroRNA(miRNA)has become a hotspot in the field of cardiovascular research.It is a kind of small molecule endogenous non-coding RNA,which was found in nematode in 1993.At present,many studies have confirmed that miRNA molecules play an important role in cardiac pathology and physiological processes such as cardiac development,cardiac hypertrophy and arrhythmia.Based on the above research,this study suggests that miR-27 b may be a new biomarker and therapeutic target in the field of HTN-LVH,but this study is more limited in animal experiments,but less in clinical human blood test.Therefore,the relationship between miRNAs and cardiac hypertrophy in the diagnosis of hypertensive patients and the significance of exosome in the induction of left ventricular hypertrophy are very necessary.【Aims】To explore the expression level of exosomal miR-27 b in patients with hypertension and whether is valuable to diagnosis of HTN-LVH.【Method】1.Collect specimensIn this study,94 patients who were hospitalized in the Second Affiliated Hospital of Guangzhou Medical University from January 2010 to April 2015 were collected in strict accordance with the inclusion criteria and exclusion criteria.A total of 94 patients who met the study were enrolled.For the HTN-LVH group(n = 38)and hypertensive without hypertrophy in the control group(n = 56).The levels of age,sex,body weight,smoking,alcohol consumption,systolic blood pressure,diastolic blood pressure,fasting blood glucose,glycosylated hemoglobin,alanine aminotransferase,aspartate aminotransferase,creatine kinase,creatine kinase isoenzyme,total Triglyceride,total cholesterol,low density lipoprotein cholesterol,high density lipoprotein cholesterol,creatinine,lactate dehydrogenase,B brain natriuretic peptide,left ventricular diameter,right ventricular diameter,left ventricular posterior wall thickness,Ventricular septal thickness and left ventricular ejection fraction.The next morning fasting blood,installed in the test tube containing sodium citrate anticoagulant.2.Save and ExtractionBlood was collected and centrifuged within 2 hours to remove red blood cells,platelets and some large fragments.Place the plasma after centrifugation at-80 ° C.To be finally thawed,each sample is divided into two groups,a group of 200 ul to detect the total miRNAs,a group of 2000 ul after extraction of exosomes,and then measured miRNAs.3.qRT-PCRThe number of miR-27 b in each test tube was detected by real-time quantitative reverse transcription polymerase chain reaction(qRT-PCR).4.Statistical analysisSPSS 17.0 statistical software was used to analyze all the statistical data what uesd with the variance homogeneity and normality test respective.Equivalent to the results what were expressed as mean ± standard deviation,in contrast,expressed with the median.Comparison of the relative expression of miR-27 b in HTN-LVH group and hypertensive hypertrophy group can be compared by t-test,the ratio of exosomes in plasma was also analyzed by t-test between different groups.Pearson correlation analysis was used to investigate the relationship between miRNA-27 b and wall thickness in exosomes.The diagnostic value of miR-27 b in the exosomes was evaluated using the receiver operating characteristic curve(ROC curve).All analysis testing methods,P <0.05 was considered statistically significant.【Results】1.The expression of miR-27 b of hypertensive left ventricular hypertrophy group was significantly higher than control group(P <0.05).2.The expression of exosomal miR-27 b of HTN-LVH group was positively correlated with IVSd and LVPWd.3.The area under the curve of exosomal miR-27 b was 0.96,the sensitivity was 86.7% and the specificity was 96.7%.AUC of Plasma miR-27 b was 0.86,the sensitivity was 73.3%,the specificity was 80%.【Conclusion】1.The expression of exosomal miR-27 b and plasma miR-27 b was positively correlated with hypertensive left ventricular hypertrophy,and elevated miR-27 b suggests a risk of hypertensive left ventricular hypertrophy.2.Exosome-derived miR-27 b is more sensitive and specific than plasma-derived. |
PDF Full Text Request