Evaluation of microribonucleic acids as potential biomarkers in the bicuspid aortic valve-associated aortopathy

OBJECTIVES: We aimed to evaluate the impact of microRNAs to predict the bicuspid aortic valve (BAV)-associated aortopathy. METHODS: Sixty-three BAV patients (mean age 47 +/- 11 years, 92% men) with root dilatation, who underwent aortic valve +/- proximal aortic surgery (mean post-AVR follow-up 10.3 +/- 6.9 years) were included. The BAV aortopathy entities were categorized in the 'less dilated' (aortic root <50 mm) and 'severely dilated' (aortic root >= 50 mm) aorta. Several microRNAs were assessed using polymerase chain reaction. Endpoints were the correlation between microRNAs and severity of aortopathy/prevalence of adverse aortic events. RESULTS: Circulating levels of miR-17 and miR-106a were strongly correlated (r = 0.84, P < 0.001). Our analysis yielded significantly higher values of miR-17 (delta Ct 2.09 +/- 0.64 vs delta Ct 1.68 +/- 0.64, P = 0.02) and miR-106a (delta Ct 5.88 +/- 0.43 vs delta Ct 5.61 +/- 0.60, P = 0.046) in BAV patients with the less dilated versus the severely dilated aorta. miR-17 (delta Ct 1.51 +/- 0.73 vs delta Ct 2.00 +/- 0.61, P = 0.02) and miR-106a (delta Ct 5.39 +/- 0.69 vs delta Ct 5.85 +/- 0.44, P = 0.007) were significantly downregulated in BAV patients who experienced adverse aortic events. CONCLUSIONS: Expression of circulating miR-17 and miR-106a in the BAV root phenotype patients correlates with the severity of aortopathy and the risk of adverse aortic events. MicroRNAs have the potential to serve as biomarkers in the BAV-associated aortopathy.