Key result
Six circulating exosome lncRNAs identify persistent AF with an AUC of ~80%.
Why the study?
Genetic characteristics implicated in AF pathogenesis are not completely clarified, and the potential role of circulating exosome lncRNAs as clinical biomarkers in AF diagnosis and prognosis remains unknown.
Observational (n=215)
Effect estimate: AUC 80.34%
Circulating exosome lncRNAs are differentially expressed in atrial fibrillation, correlate with atrial structural remodeling, and may serve as diagnostic biomarkers for persistent AF.
May support exosome lncRNA panels for persistent AF diagnosis; hypothesis-generating and requires prospective validation before clinical use.
Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia with severe clinical sequelae, but its genetic characteristic implicated in pathogenesis has not been completely clarified. Accumulating evidence has indicated that circulating exosomes and their carried cargoes, such as long non-coding RNAs (lncRNAs), involve in the progress of multiple cardiovascular diseases. However, their potential role as clinical biomarkers in AF diagnosis and prognosis remains unknown. Methods: Herein, we conducted the sequence and bioinformatic analysis of circulating exosomes harvested from AF and sinus rhythm patients. Results: A total of 53 differentially expressed lncRNAs were identified, and a total of 6 significantly changed lncRNAs (fold change > 2.0), including NR0046235, NR003045, NONHSAT167247.1, NONHSAT202361.1, NONHSAT205820.1 and NONHSAT200958.1, were verified by qRT-PCR in 215 participants. Moreover, these circulating exosome lncRNA levels were different between paroxysmal and persistent AF patients, which were dramatically associated with abnormal hemodynamics and atrial diameter. Furthermore, we observed that the area under ROC curve (AUC) of six lncRNAs combination for diagnosis of persistent AF was 80.34%. Gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) enrichment pathway analysis indicated these exosome lncRNAs mainly concerning response to chemokine-chemokine receptor interaction, which induced activated inflammation and structural remodeling. In addition, increased plasma levels of CXCR3 ligands, including CXCL4, CXCL9, CXCL10 and CXCL11, were accumulated in AF patient tissues. Conclusion: Our study provides the transcriptome profile revealing pattern of circulating exosome lncRNAs in atrial structural remodeling, which bring valuable insights into improving prognosis and therapeutic targets for AF.
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Yuan et al. (2024) conducted an observational in Atrial fibrillation (n=215). Circulating exosome lncRNAs vs. Sinus rhythm was evaluated on Diagnosis of persistent AF (AUC 80.34%). A combination of six circulating exosome lncRNAs yielded an area under the ROC curve of 80.34% for the diagnosis of persistent atrial fibrillation.
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