Background: The limitation of aortic size-based criteria is gradually
recognized in the prediction of aortic events especially in bicuspid aortic valve
(BAV) cohorts, while most aortic events happen in patients with proximal aortic
diameters 50 mm. Circulating microRNAs (miRs) have been addressed as a novel
tool to improve risk stratification in patients with different aortopathies. We
aimed to elucidate the correlation between peripheral whole blood and aortic
tissue miRs in order to prove the potential availability as a biomarker in the
clinical routine. Methods: All patients who received elective aortic
valve repair/replacement proximal aortic replacement to BAV disease (n =
65, 2013–2018) were prospectively included. The expression of 10 miRs (miR-1,
miR-17, miR-18a, miR-19a, miR-20a, miR-21, miR-106a, miR-133a, miR-143 and
miR-145) was analyzed in the intraoperatively acquired aortic tissue as well as
in the peripheral blood before the surgery. Results: We found a
significant correlation between circulating miRs in the peripheral blood and
aortic tissue levels of miR-21 (r = 0.293, p = 0.02), miR-133a (r =
0.43, p = 0.02), miR-143 (r = 0.68, p 0.001), and miR-145
(r = 0.68, p 0.001). Further, the multivariate logistic regression
analysis revealed an association between blood and aortic tissue miR-143 levels
each other (Odds Ratio [OR] 1.29, 95% Confidence Interval [CI] 1.11–1.67,
p = 0.02; OR 1.36, 95% CI 1.19–2.01, p = 0.03, respectively)
and a blood/aortic miR-143 level to dilated aorta (OR 3.61, 95% CI 1.62–9.02,
p = 0.01; OR 2.92, 95% CI 1.81–7.05, p = 0.02, respectively).
Conclusions: Our study demonstrates a significant correlation between
peripheral whole blood and aortic tissue miRs, confirming the hypothesis that
circulating miRs may reflect remodeling processes in the proximal aorta in
bicuspid aortopathy patients.