AUTHOR=Shen Yanming , Liao Dongshan , Shangguan Wenlin , Chen Liangwan 

TITLE=Variation and significance of serum microRNA-21 level in pediatric pulmonary artery hypertension associated with congenital heart disease

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1424679

DOI=10.3389/fcvm.2024.1424679

ISSN=2297-055X

ABSTRACT=<sec><title>Objective</title><p>This study strives to the variation and significance of microRNA-21 (<italic>miR-21</italic>) in children with congenital heart disease (CHD)-related pulmonary artery hypertension (PAH).</p></sec><sec><title>Methods</title><p>Children with CHD (<italic>n</italic> = 179) were selected as subjects, including 101 children without PAH and 78 children with PAH. All children underwent general data collection, laboratory examination, echocardiography and cardiac catheterization. After detection of serum <italic>miR-21</italic> expression, the predictive value and the impacts of serum <italic>miR-21</italic> for PAH and postoperative critical illness were analyzed.</p></sec><sec><title>Results</title><p>Serum creatine kinase isoenzyme (CK-MB), B-type natriuretic peptide (BNP) and <italic>miR-21</italic> were elevated, but ejection fraction (EF) and cardiac index (CI) were decreased in the CHD-PAH group. Serum <italic>miR-21</italic> assisted in predicting PAH in CHD children, with the area under curve (AUC) of 0.801 (95% CI of 0.735∼0.857), a cut-off value of 2.56, sensitivity of 73.08, and specificity of 72.28%. Serum <italic>miR-21</italic> in children with CHD-PAH was correlated with clinicopathological indicators such as systolic pulmonary artery pressure, mean pulmonary arterial pressure, BNP and CI. Serum <italic>miR-21</italic> helped predict the development of postoperative critical illness in children with CHD-PAH, with an AUC of 0.859 (95% CI: 0.762–0.927, cut-off value: 4.55, sensitivity: 69.57%, specificity: 92.73%). Increased serum <italic>miR-21</italic> was an independent risk factor of postoperative critical illness in children with CHD-PAH.</p></sec><sec><title>Conclusion</title><p>Serum <italic>miR-21</italic> was upregulated in children with CHD-PAH, which may serve as a predictive biomarker for the onset of PAH and postoperative critical illness in CHD children.</p></sec>