Relationship between serum microRNA-22 and HSPB1 levels and prognosis of patients with acute Stanford type A aortic dissection

doi:10.3877/cma.j.issn.1674-0785.2023.03.002

Abstract

Abstract:

Objective

To investigate the relationship between serum microRNA-22 (miR-22) and heat shock protein family B (small) member 1 (HSPB1) levels and the prognosis of patients with acute Stanford type A aortic dissection (ATAAD).

Methods

A total of 145 patients with ATAAD admitted to our hospital from January 2020 to May 2022 (ATAAD group) were selected and divided into either a death group (22 cases) or a survival group (123 cases) according to their in-hospital survival status, and another 52 healthy individuals who underwent physical examination during the same period were selected as a control group. Clinical data of ATAAD patients were collected and serum miR-22 and HSPB1 levels were measured by qPCR and enzyme-linked immunosorbent assay. Multi-factor logistic regression was used to analyze the factors influencing death in ATAAD patients, and ROC curve analysis was performed to assess the predictive value of serum miR-22 and HSPB1 levels for death in ATAAD patients.

Results

Serum miR-22 levels were lower in the ATAAD group than in the control group, and HSPB1 levels were higher than those in the control group (P＜0.05). Multifactorial logistic regression analysis showed that increased age (OR=1.077, 95% CI: 1.001 to 1.158), myocardial infarction (OR=2.963, 95% CI: 1.156 to 7.597), shock (OR=3.178, 95% CI: 1.209 to 8.359), pericardial effusion (OR=2.684, 95% CI: 1.067 to 6.751), and elevated HSPB1 (OR=1.256, 95% CI: 1.013 to 1.557) were independent risk factors for death in ATAAD patients, and elevated miR-22 (OR=0.417, 95% CI: 0.196 to 0.888) was an independent protective factor (P＜0.05). ROC curve analysis showed that the area under the curve values of serum miR-22 and HSPB1 levels alone and in combination for predicting death in ATAAD patients were 0.792, 0.782, and 0.873, respectively, with sensitivities of 81.82%, 59.09%, and 86.36% and specificities of 73.98%, 88.62%, and 76.42%, respectively.

Conclusion

Decreased serum miR-22 levels and increased HSPB1 levels are independently associated with a poor prognosis in ATAAD patients and can be used as an auxiliary predictor of poor prognosis in ATAAD patients.

Key words: Acute Stanford type A aortic dissection, MicroRNA-22, Heat shock protein family B (small) member 1, Vascular smooth muscle cells, Prognosis

Yang Zhou, Xue Cao, Fei Zhao, Bo Zheng, Huijuan Zha, Na Jiang, Jun Luo, Wei Xiong. Relationship between serum microRNA-22 and HSPB1 levels and prognosis of patients with acute Stanford type A aortic dissection[J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(03): 243-248.

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Figures/Tables 4

临床资料	死亡组（n＝22）	存活组（n＝123）	χ²/t/U值	P值
性别（男/女）	14/8	87/36	0.444	0.505
年龄（岁， $x ¯$ ±s）	67.59±9.33	58.98±9.92	3.779	＜0.001
体质指数（kg/m²， $x ¯$ ±s）	25.21±2.28	24.16±2.62	1.765	0.080
吸烟史［n（％）］	12（54.55）	51（41.46）	1.300	0.254
合并症［n（％）］
高血压	14（63.64）	89（72.36）	0.690	0.406
糖尿病	6（27.27）	46（37.40）	0.832	0.362
动脉粥样硬化	5（22.73）	25（20.33）	＜0.001	1.000
Marfan综合征	2（9.09）	6（4.88）	0.084	0.772
夹层起源部位［n（％）］			0.686	0.710
主动脉根部	10（45.45）	46（37.40）
主动脉弓部	1（4.55）	4（3.25）
升主动脉	11（50.00）	73（59.35）
心电图［n（％）］			10.234	0.017
正常	5（22.73）	54（43.90）	3.467	0.063
左心室肥厚	3（13.64）	35（28.46）	2.119	0.145
心肌缺血	9（40.91）	27（21.95）	5.424	0.020
心肌梗死	5（22.73）	7（5.69）	5.067	0.024
发病至手术时间［h，M（P25，P75）］	4.00（3.00，6.25）	4.00（3.00，5.00）	1.329	0.184
并发症［n（％）］
休克	9（40.91）	22（17.89）	5.885	0.015
肾功能衰竭	1（4.55）	6（4.88）	＜0.001	1.000
升主动脉瘤或升主动脉根部瘤	2（9.09）	12（9.76）	＜0.001	1.000
主动脉壁内血肿	1（4.55）	6（4.88）	＜0.001	1.000
主动脉周围血肿	7（31.82）	28（22.76）	0.835	0.361
主动脉瓣关闭不全	12（54.55）	62（50.41）	0.128	0.721
心包积液	12（54.55）	38（30.89）	4.621	0.032
收缩压（mmHg， $x ¯$ ±s）	170.86±24.25	168.16±18.21	0.498	0.623
舒张压［mmHg，M（P25，P75）］	97.50（86.75，107.00）	95.00（89.00，100.00）	0.921	0.357
心率（次/min， $x ¯$ ±s）	95.27±18.05	90.65±16.54	1.120	0.272
TC（mmol/L， $x ¯$ ±s）	5.63±0.46	5.42±0.56	1.639	0.103
TG（mmol/L， $x ¯$ ±s）	1.63±0.22	1.54±0.31	1.220	0.225
HDL-C（mmol/L， $x ¯$ ±s）	1.06±0.11	1.08±0.13	0.740	0.461
LDL-C（mmol/L， $x ¯$ ±s）	2.83±0.35	2.82±0.39	0.167	0.868
白细胞计数（×10⁹/L， $x ¯$ ±s）	14.50±3.20	12.09±4.05	2.646	0.009
血小板计数（×10⁹/L， $x ¯$ ±s）	219.75±18.45	228.45±22.74	1.969	0.092
淋巴细胞计数（×10⁹/L， $x ¯$ ±s）	1.25±0.61	1.60±0.65	2.352	0.020
miR-22（ $x ¯$ ±s）	0.87±0.14	1.08±0.28	5.758	＜0.001
HSPB1（ng/ml， $x ¯$ ±s）	3.78±0.57	3.09±0.57	5.269	＜0.001

临床资料	死亡组（n＝22）	存活组（n＝123）	χ²/t/U值	P值
性别（男/女）	14/8	87/36	0.444	0.505
年龄（岁， $x ¯$ ±s）	67.59±9.33	58.98±9.92	3.779	＜0.001
体质指数（kg/m²， $x ¯$ ±s）	25.21±2.28	24.16±2.62	1.765	0.080
吸烟史［n（％）］	12（54.55）	51（41.46）	1.300	0.254
合并症［n（％）］
高血压	14（63.64）	89（72.36）	0.690	0.406
糖尿病	6（27.27）	46（37.40）	0.832	0.362
动脉粥样硬化	5（22.73）	25（20.33）	＜0.001	1.000
Marfan综合征	2（9.09）	6（4.88）	0.084	0.772
夹层起源部位［n（％）］			0.686	0.710
主动脉根部	10（45.45）	46（37.40）
主动脉弓部	1（4.55）	4（3.25）
升主动脉	11（50.00）	73（59.35）
心电图［n（％）］			10.234	0.017
正常	5（22.73）	54（43.90）	3.467	0.063
左心室肥厚	3（13.64）	35（28.46）	2.119	0.145
心肌缺血	9（40.91）	27（21.95）	5.424	0.020
心肌梗死	5（22.73）	7（5.69）	5.067	0.024
发病至手术时间［h，M（P25，P75）］	4.00（3.00，6.25）	4.00（3.00，5.00）	1.329	0.184
并发症［n（％）］
休克	9（40.91）	22（17.89）	5.885	0.015
肾功能衰竭	1（4.55）	6（4.88）	＜0.001	1.000
升主动脉瘤或升主动脉根部瘤	2（9.09）	12（9.76）	＜0.001	1.000
主动脉壁内血肿	1（4.55）	6（4.88）	＜0.001	1.000
主动脉周围血肿	7（31.82）	28（22.76）	0.835	0.361
主动脉瓣关闭不全	12（54.55）	62（50.41）	0.128	0.721
心包积液	12（54.55）	38（30.89）	4.621	0.032
收缩压（mmHg， $x ¯$ ±s）	170.86±24.25	168.16±18.21	0.498	0.623
舒张压［mmHg，M（P25，P75）］	97.50（86.75，107.00）	95.00（89.00，100.00）	0.921	0.357
心率（次/min， $x ¯$ ±s）	95.27±18.05	90.65±16.54	1.120	0.272
TC（mmol/L， $x ¯$ ±s）	5.63±0.46	5.42±0.56	1.639	0.103
TG（mmol/L， $x ¯$ ±s）	1.63±0.22	1.54±0.31	1.220	0.225
HDL-C（mmol/L， $x ¯$ ±s）	1.06±0.11	1.08±0.13	0.740	0.461
LDL-C（mmol/L， $x ¯$ ±s）	2.83±0.35	2.82±0.39	0.167	0.868
白细胞计数（×10⁹/L， $x ¯$ ±s）	14.50±3.20	12.09±4.05	2.646	0.009
血小板计数（×10⁹/L， $x ¯$ ±s）	219.75±18.45	228.45±22.74	1.969	0.092
淋巴细胞计数（×10⁹/L， $x ¯$ ±s）	1.25±0.61	1.60±0.65	2.352	0.020
miR-22（ $x ¯$ ±s）	0.87±0.14	1.08±0.28	5.758	＜0.001
HSPB1（ng/ml， $x ¯$ ±s）	3.78±0.57	3.09±0.57	5.269	＜0.001

因素	β值	SE值	Wald χ²值	P值	OR值	95％CI值
年龄增加	0.074	0.037	3.972	0.046	1.077	1.001~1.158
心肌缺血	0.353	0.181	1.701	0.192	1.423	0.998~2.028
心肌梗死	1.086	0.480	4.309	0.038	2.963	1.156~7.597
休克	1.156	0.493	5.494	0.019	3.178	1.209~8.359
心包积液	0.987	0.471	4.403	0.036	2.684	1.067~6.751
白细胞计数升高	0.351	0.161	3.476	0.062	1.209	1.097~1.333
淋巴细胞计数升高	-0.366	0.526	0.483	0.487	0.694	0.247~1.946
miR-22升高	-0.847	0.385	8.416	0.004	0.417	0.196~0.888
HSPB1升高	0.028	0.110	7.499	0.006	1.256	1.013~1.557

指标	AUC	95％CI值	临界值	敏感度（％）	特异度（％）	Youden指数
miR-22	0.792	0.717~0.855	0.96	81.82	73.98	0.558
HSPB1	0.782	0.706~0.846	3.76 ng/ml	59.09	88.62	0.477
二者联合	0.873	0.807~0.922	-	86.36	76.42	0.628

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