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Analysis of plasma miRNA of patients in the cardiac surgery preoperative period who developed the vasoplegic syndrome

Abstract

Cardiovascular diseases (CVD) account for approximately 20% of all causes of death in Brazil in individuals over 30 years. In 2014 were carried out a total number of 92,000 heart surgeries in Brazil and these are usually performed using extracorporeal circulation (ECC), which is made by the diversion of blood circulation of the lungs and heart to a heart-lung machine, which keeps cardiocirculatory functions and oxygenates the blood. Despite enable various types of major cardiac surgery, the use of ECC can cause serious side effects such as post perfusion syndrome or vasoplegic (VS). This also known as vasoplegia, is characterized by increased cardiac output, hypotension, systemic inflammatory response and decreased vascular resistance, affecting frequently (incidence 9-44%) patients in the postoperative period of cardiac surgery, with a mortality of 27%. Treatments for VS are limited and the drugs are often ineffective, including noradrenaline, vasopressin, and methylene blue. Another difficulty encountered by the surgeon is to establish a predictive factor for VS. Systems risk predictors that use score and are well validated as EuroScore (European System for Cardiac Operative Risk Evaluation) have not been tested for VS. Much has been studied on the use of biomarkers as predictors and for prognosis as well as to improve predictive power of the rating systems available. MicroRNAs (miRNAs or miRs) are noncoding RNA molecules that control gene expression in the intracellular environment and are present circulating in various body fluids including peripheral blood. These molecules can be used as biomarkers of various pathologies including CVD. Despite the existence of numerous studies that demonstrate the importance of miRNAs in the development of CVDs. There are no studies that address the issue in VS Therefore, the objective of the project is to identify the presence of plasma miRNAs that are altered in patients with preoperative cardiovascular surgery and assess whether these miRNAs can be used as predictors and biomarkers of mortality for VS. (AU)