Secondary mitral regurgitation-Insights from microRNA assessment.

BACKGROUND: While secondary mitral regurgitation (sMR) is associated with adverse outcome in heart failure with reduced ejection fraction (HFrEF), key pathophysiologic mechanisms remain poorly understood and might be elucidated by microRNAs (miRNA/miR), that were recently related to cardiac remodelling. This study sought to assess (i) the differences of miRNA profiles in patients with severe sMR compared to matched disease controls, (ii) the correlation between circulating miRNAs and surrogates of sMR severity as well as (iii) the prognostic implications of miRNA levels in severe sMR. MATERIALS AND METHODS: Sixty-six HFrEF patients were included, of these 44 patients with severe sMR 2:1 matched to HFrEF controls with no/mild sMR. A comprehensive set of miRNAs (miR-21, miR-29a, miR-122, miR-132, miR-133a, miR-let7i) were measured and correlated to echocardiographic sMR severity. RESULTS: miRNA patterns differed distinctly between patients with severe sMR and HFrEF controls (P < .05). Among the panel of assessed miRNAs, miR-133a correlated most strongly with surrogates of sMR severity (r = -0.41, P = .001 with sMR vena contracta width). Interestingly, elevated levels of miR-133 were associated with an increased risk for cardiovascular death and/or HF hospitalizations with and adjusted HR of 1.85 (95% CI 1.24-2.76, P = .003). CONCLUSIONS: This study unveils distinct pathophysiologic maladaptions at a cellular level in patients with severe sMR compared to no/mild sMR by showing significant differences in miRNA profiles and correlations with sMR severity, supporting the concept that sMR drives cardiac remodelling in heart failure. Moreover, the increased risk for adverse outcome in HFrEF patients with severe sMR conveyed by miR-133a might indicate irreversible myocardial damage.

Is Perceptual Priming Affected by Culture? A Study With German Middle-Class and Cameroonian Nso Farmer Children.

The authors explored priming in children from different cultural environments with the aim to provide further evidence for the robustness of the priming effect. Perceptual priming was assessed by a picture fragment completion task in 3-year-old German middle-class and Cameroonian Nso farmer children. As expected, 3-year-olds from both highly diverging cultural contexts under study showed a priming effect, and, moreover, the effect was of comparable size in both cultural contexts. Hence, the children profited similarly from priming, which was supported by the nonsignificant interaction between cultural background and identification performance as well as the analysis of absolute difference scores. However, a culture-specific difference regarding the level of picture identification was found in that German middle-class children identified target as well as control pictures with less perceptual information than children in the Nso sample. Explanations for the cross-cultural demonstration of the priming effect as well as for the culturally diverging levels on which priming occurs are discussed.