Identification of Plasmatic MicroRNA-206 as New Predictor of Early Recurrence of Atrial Fibrillation After Catheter Ablation Using Next-generation Sequencing.

BACKGROUND: Catheter ablation (CA) of atrial fibrillation (AF) is indicated in patients with recurrent and symptomatic AF episodes. Despite the strict inclusion/exclusion criteria, AF recurrence after CA remains high. Identification of a novel biomarker that would predict AF recurrence would help to stratify the patients. The aim of the study was to seek novel biomarkers among the plasmatic microRNAs (miRNAs, miRs). METHODS: A prospective monocentric study was conducted. A total of 49 consecutive AF patients indicated for CA were included. Blood sampling was performed prior to CA. RNA was isolated from plasma using commercial kits. In the exploration phase, small RNA sequencing was performed in ten AF patients (five with and five without AF recurrence) using Illumina instrument. In the validation phase, levels of selected miRNAs were determined using quantitative reverse transcription polymerase chain reaction (qRT-PCR) in all participants. RESULTS: Altogether, 22 miRNAs were identified as altered between the groups by next-generation sequencing (using the DESeq2 algorithm). Using qRT-PCR, levels of the five most altered miRNAs (miR-190b/206/326/505-5p/1296-5p) were verified in the whole cohort. Plasma levels of hsa-miR-206 were significantly higher in patients with early (within 6 months) AF recurrence and showed an increase of risk recurrence,2.65 times by every increase in its level by 1 unit in the binary logistic regression. CONCLUSION: We have identified a set of 22 plasmatic miRNAs that differ between the patients with and without AF recurrence after CA and confirmed hsa-miR-206 as a novel miRNA associated with early AF recurrence. Results shall be verified in a larger independent cohort.

Endoscopic diagnostics and therapy of pancreatobiliary diseases in persons after gastric resection according to Billroth I.

The stomach resection according to Billroth I (B I) is very rarely done. The aim of this retrospective study is to evaluate our experience with diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in patients after stomach resection according to Billroth I. In patients with a condition after stomach resection according to B I, a study of the group of 20 years (November 1994 - December 2014) took place. Three patients were evaluated retrospectively after B I stomach resection with biliary obstruction. For the ERCP was used the Olympus therapeutic videotheroscop in all cases with the standard (as in normal anatomical situation). Cannulation success in diagnostic ERCP was achieved in 3 out of 3 patients - 100% success rate of ERC diagnosis. For all these 3 patients CDL was found in the ERCP. In addition, endoscopic treatment was performed immediately after ERCP diagnosis in all 3 patients with a CDL pathologic ERCP diagnosis, the initial endoscopic papillotomy (EPT) performed in the standard procedure (as in normal anatomy). Subsequently, endoscopic extraction of all CDL from hepatocholedocus to duodenum was performed. Overall the ERCP was completely successful in all 3 of the 3 (100% of 3) patients who initially started endoscopic therapy. There were no complications in our group of 3 patients. For ERCP in patients with BI stomach resection, we had 100% success rate of diagnostic and therapeutic ERCP in all of these patients (3 CDL patients).

Rivaroxaban in COMPASS trial.

Cardiovascular diseases (CVD) are still at the first place in the case of mortality in European countries. Consistent secondary prevention for CVD is very important aspect in the fight with this negative statistics. We consider antithrombotic treatment as a gold standard in secondary prevention for CVD . There are a lot of latest trials about this problematics. COMPASS trial targets the effectiveness of rivaroxaban in patients with CVD as a secondary prevention. The results of this trial are very positive about using rivaroxaban and acetylsalicylic acid together in effort to avoid progression or relapse of CVD.

Non-coding RNAs and Cardiac Arrhythmias.

Cardiac arrhythmias represent wide and heterogenic group of disturbances in the cardiac rhythm. Pathophysiology of individual arrhythmias is highly complex and dysfunction in ion channels/currents involved in generation or spreading of action potential is usually documented. Non-coding RNAs (ncRNAs) represent highly variable group of molecules regulating the heart expression program, including regulation of the expression of individual ion channels and intercellular connection proteins, e.g. connexins.Within this chapter, we will describe basic electrophysiological properties of the myocardium. We will focus on action potential generation and spreading in pacemaker and non-pacemaker cells, including description of individual ion channels (natrium, potassium and calcium) and their ncRNA-mediated regulation. Most of the studies have so far focused on microRNAs, thus, their regulatory function will be described into greater detail. Clinical consequences of altered ncRNA regulatory function will also be described together with potential future directions of the research in the field.