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MiRNA-208a as a Sensitive Early Biomarker for the Postoperative Course Following Congenital Heart Defect Surgery

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Abstract

Current clinical risk assessment strategies have poor accuracy for identifying patients who will suffer adverse perioperative events. There is an ongoing need to integrate clinical variables with novel technology and biomarkers to accurately predict outcome after pediatric heart surgery. We tested the hypothesis that miRNAs-208a, -208b, and -499 can serve as noninvasive biomarkers for the extent of myocardial damage and the postoperative clinical course of pediatric patients with congenital heart defects (CHDs) at an early time point following surgery. Serum samples were obtained from 79 pediatric patients before and 6, 12, and 24 h after surgery. MiRNAs-208a, -208b, and -499 were quantified by RQ-PCR. Correlations between the patient’s clinical variables and miRNA levels were tested. Our results show that the levels of the three miRNAs were elevated at 6 h after surgery, remained high at 12 h and declined at 24 h after the operation. The amount of all three miRNAs at 6 h after surgery correlated with surgical and laboratory parameters. Their amount at 12 h after surgery correlated with the length of stay at the hospital. Expression levels of miRNA-208a at 6 h were related to the appearance of cardiac complications, and could predict whether a patient will sustain complications or will be ventilated for more than 48 h after surgery. Circulating miRNA-208a is a predictor for the risk of developing cardiac complications during the postoperative course as early as 6 h after heart surgery for CHD in pediatric patients.

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Acknowledgements

We thank Amisragas for their continuous support of the Department of Intensive Care. Esther Eshkol is thanked for editorial assistance.

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    Authors and Affiliations

    1. Department of Pediatric Critical Care Medicine, Safra Children’s Hospital, Sheba Medical Center, Ramat-Gan, Israel

      Keren Zloto, Yoav Bolkier, Omer Bar-Yosef, Yael Nevo-Caspi & Gidi Paret

    2. Sackler Medical School, Tel-Aviv University, Tel-Aviv, Israel

      Keren Zloto & Gidi Paret

    3. Department of Pediatric Cardiology, Safra Children’s Hospital, Sheba Medical Center, Ramat-Gan, Israel

      Tal Tirosh-Wagner

    4. Department of Pediatric Cardiac Intensive Care, Safra Children’s Hospital, Sheba Medical Center, Ramat-Gan, Israel

      Amir Vardi

    5. Department of Pediatric Cardiac Surgery, Safra Children’s Hospital, Sheba Medical Center, Ramat-Gan, Israel

      David Mishali

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    1. Keren Zloto
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    2. Tal Tirosh-Wagner
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    Corresponding author

    Correspondence to Yael Nevo-Caspi.

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    All authors declare they have no conflict of interest.

    Ethical Approval

    All procedures were performed in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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    Informed consent was obtained from the legal representatives of all individual participants included in the study.

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    Keren Zloto and Tal Tirosh-Wagner have contributed equally to this work.

    Yael Nevo-Caspi and Gidi Paret have contributed equally to this work.

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    Zloto, K., Tirosh-Wagner, T., Bolkier, Y. et al. MiRNA-208a as a Sensitive Early Biomarker for the Postoperative Course Following Congenital Heart Defect Surgery. Pediatr Cardiol 39, 1565–1571 (2018). https://doi.org/10.1007/s00246-018-1931-7

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    • DOI: https://doi.org/10.1007/s00246-018-1931-7

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