Association between the transporters ABCA1/G1 and the expression of miR-33a/144 and the carotid intima media thickness in patients with arterial hypertension.

ATP-binding cassette membrane transporters (ABC), functions as an outflow facilitator of phospholipids and cellular cholesterol, playing an important role in the development of atherosclerosis and arterial hypertension. ABC's transporters could post-transcriptionally regulated by miRs. Evaluate the association in the transporters ABCA1 and ABCG1 with the expression of miR-33a and miR-144 and the carotid intima media thickness (cIMT) in patients with essential arterial hypertension. The miR-33a-5p, miR-144-3p and mRNA ABCA1 and ABCG1 expression in monocytes from Mexican hypertensive patients were examined by RT-PCR. The miR-33a and miR-144 expression in monocytes and mRNA ABCA1 and ABCG1 from Mexican hypertensive patients were examined by RT-PCR. This study involved 84 subjects (42 normotensive subjects and 42 patients with essential hypertension). Our study revealed that miR-33a expression (p = 0.001) and miR-144 (p = 0.985) were up-regulated, meanwhile, ABCA1 and ABCG1 transporters were down-regulated (p = 0.007 and p = 0.550 respectively) in hypertensive patients compared with the control group. The trend remains for miR33a/ABCA1 in presence of cIMT. Moreover, an inverse correlation was found with the expression levels of ABCA1 and ABCG1 as well as in HDL-C with miR-33a and miR-144. Our results showed an increase in the expression of miR-33a and miR-144 and an inverse correlation in their target ABCA1 and ABCG1; it may be associated with essential arterial hypertension in patients with cIMT and as consequence for atheromatous plaque.

The role of the osteoprotegerin/RANKL/RANK axis and osteopontin in acute coronary syndrome.

Objectives: The primary objective of this study is to ascertain the levels of osteoprotegerin (OPG) and osteopontin (OPN), alongside osteoprotegerin/RANKL ratio (ORR), and assess their association with the SYNTAX score and ascertain the potential of these molecules as predictive markers for risk, aiding in risk stratification. Eventually, they could potentially be employed even before angiography to gauge the severity of coronary lesions. Methods: Prospective study with 147 participants, 101 (69%) were men, with an average age of 60. We included three groups - (1) patients with acute coronary syndrome undergoing percutaneous coronary intervention (ACS-PCI), (2) patients without ACS who underwent coronary angiography for an indication other than ischemia and did not undergo PCI (non-ACS without), and (3) one asymptomatic subject. OPG and OPN were measured. ORR and SYNTAX scores were calculated. The association between OPG and OPN levels and important clinical variables was investigated. Results: OPG levels in Group 1 were lower compared to Groups 2 and 3 (controls), Group 1 (490 pg/mL) versus Group 2 (829 pg/mL) versus Group 3 (845 pg/mL) (p = 0.001). OPG had lower levels in patients with coronary artery stenosis versus without stenosis. A decrease in ORR was shown in all groups and no association with the SYNTAX score. Conclusion: OPG and OPN (and ORR) levels are decreased in patients with ACS and show no correlation with the SYNTAX score. As an exploratory study, our work suggest that increased OPG and OPN levels in non-ACS patients may have, in fact, a protective effect. This study is one of the few with an appropriate control in ACS and reproducibility is necessary mainly with multicenter studies.

Objetivo: El objetivo principal de este estudio es conocer los niveles de OPG y OPN, junto con la ORR, y evaluar su asociación con la puntuación SYNTAX y conocer el potencial de estas moléculas como marcadores predictivos de riesgo, ayudando en la estratificación del riesgo. Con el tiempo, podrían emplearse incluso antes de la angiografía para medir la gravedad de las lesiones coronarias. Métodos: Estudio prospectivo con 147 participantes, 101 (69%) eran hombres, con una edad promedio de 60 años. Se incluyeron tres grupos (1) pacientes con SCA sometidos a ICP (SCA-ICP), (2); pacientes sin SCA sometidos a angiografía coronaria por una indicación distinta a la isquemia y no sometidos a ICP (sin SCA sin) (3) un sujeto asintomático. Se midieron OPG, OPN. Se calcularon las puntuaciones ORR y SYNTAX. Se investigó la asociación entre los niveles de OPG y OPN y variables clínicas importantes. Resultados: Los niveles de OPG en el Grupo 1 fueron más bajos en comparación con los Grupos 2 y 3 (controles). Grupo 1 (490 pg/mL) versus Grupo 2 (829 pg/mL) versus Grupo 3 (845 pg/mL) [p = 0.001]). La OPG tuvo niveles más bajos en pacientes con estenosis de la arteria coronaria versus sin estenosis. Se mostró una disminución en la ORR en todos los grupos y no hubo asociación con la puntuación SYNTAX. Conclusione: Los niveles de OPG OPN (y ORR) están disminuidos en pacientes con SCA y no muestran correlación con la puntuación SYNTAX. Como estudio exploratorio, nuestro trabajo sugiere que los niveles elevados de OPG y OPN en pacientes sin SCA pueden tener, de hecho, un efecto protector. Este estudio es uno de los pocos con un control adecuado en SCA y la reproducibilidad es necesaria principalmente con estudios multicéntricos.

Increased expression of miR-33a in monocytes from Mexican hypertensive patients in elevated carotid intima-media thickness.

miR-33a has been described as a key regulator in the initiation and progression of atherosclerosis. However, its role in arterial hypertension (HTA) has not been elucidated. Therefore, the aim of this study was to determine the association between the expression of miR-33a (5p and 3p) and the carotid intima-media thickness (cIMT) in samples of monocytes and serum from hypertensive patients. The miR-33a-5p and miR-33a-3p expression in monocytes and serum from Mexican hypertensive patients were examined by RT-PCR. This study involved 84 subjects (42 normotensive subjects and 42 patients with essential hypertension). Our study revealed that miR-33a-5p expression was significantly upregulated in the monocytes of hypertensive patients compared with the control group (p = 0.001), while miR-33a-3p was significantly downregulated (p = 0.013). miR-33a-5p upregulation [OR: 5.53, 95% CI: 2.01-15.20; p = 0.001], as well as miR-33a-3p downregulation [OR: 3.32, 95% CI: 1.45-7.60; p = 0.004] in monocytes, was associated with an increased risk of developing hypertension. In addition, miR-33a-5p upregulation in hypertensive patients was associated with an increased risk of presenting cIMT [OR: 5.99, 95% CI: 1.10-32.85; p = 0.039]. Moreover, we found no significant differences in the expression of both strands of miR-33a in serum of our patients. Our results showed an upregulation of miR-33a-5p and downregulation of miR-33a-3p in monocytes, these data are associated with cIMT, which could be a risk factor for the development of hypertension. In addition, upregulation of miR-33a-5p in monocytes from Mexican hypertensive patients could be involved in the development of atherosclerosis.

Estenosis aórtica pura y resonancia magnética en el adulto / Pure aortic stenosis and magnetic resonance in adult patients

OBJECTIVE: To evaluate the utility of the cardiovascular magnetic resonance imaging (cMRI) for quantify the aortic area in adult patients with pure aortic stenosis (AS). METHOD: Comparative cross-sectional study, blinded, in patients with AS, without another valvular pathology associated. A transthoracic echocardiogram (TTE) and cMRI were performed, in all of them. Results were analyzed by Student t test and ji-square, considering significant values p < 0.05. Bayesian analysis and ROC curve, for the determination of the disease severity. RESULTS: No were significant differences with respect to quantification of the speed of transvalvular flow between both methods (TTE 4.593 +/- 0.9114 m/s vs. cMRI 4.233 +/- 0.6894 m/s, p = 0.080), nor the ejection fraction (TTE 54.27 +/-16.451 vs. cMRI 48.40 +/-17.332, p = 0.760). The cMRI seems to underestimate the maximum and medium gradients compared with the TTE, in 12.53 mm Hg and 10.07 mm Hg respectively. The sensitivity for the diagnosis of severe aortic stenosis is 90% with specificity 80%. CONCLUSIONS: The cMRI is a useful diagnostic method for the evaluation of patients with pure aortic valve stenosis, as good as TTE. cMRI can to be a diagnostic alternative in cases with limitations to TTE.