血清外泌体circ_0007478与稳定型冠状动脉疾病斑块内坏死核心体积的相关性

Correlation between Serum Exosome circ_0007478 and Necrotic Core Volume in Plaques of Stable Coronary Artery Disease

目的探讨血清外泌体circ_0007478与稳定型冠状动脉疾病(SCAD)斑块内坏死核心体积的相关性。方法选择2020年3月至2022年6月在西安国际医学中心医院行经皮冠状动脉介入术(PCI)的103例SCAD患者进行前瞻性研究。采用实时荧光定量PCR法检测血清外泌体circ_0007478水平。PCI前使用虚拟组织学血管内超声(VH-IVUS)技术评估冠状动脉斑块组织成分,包括纤维、纤维脂质、坏死核心和致密钙化,并计算每个区域占整个病变体积的百分比。采用Spearman相关分析、偏相关性分析和多元线性回归分析评估血清外泌体circ_0007478水平与SCAD患者坏死核心体积百分比的相关性。结果SCAD患者血清外泌体circ_0007478表达水平为1.20(1.04,1.42)。根据血清外泌体circ_0007478水平的中位数,将SCAD患者分为低表达组(≤1.20)和高表达组(>1.20)。与血清外泌体circ_0007478低表达组SCAD患者相比,高表达组患者血管体积、斑块体积、管腔体积、病变长度更大,坏死核心体积百分比更高(P均<0.05)。Spearman相关分析结果显示,血清外泌体circ_0007478水平与SCAD患者坏死核心体积百分比呈正相关(r=0.528,P<0.001)。坏死核心体积百分比与低密度脂蛋白胆固醇(LDL-C)水平、中性粒细胞与淋巴细胞比值(NLR)呈正相关(P<0.05)。在偏相关性分析中控制LDL-C水平和NLR后,血清外泌体circ_0007478水平与SCAD患者坏死核心体积百分比仍呈正相关性(P<0.001)。多元线性回归分析结果显示,血清外泌体circ_0007478水平是SCAD患者坏死核心体积的预测因子(β=1.567,95%CI:6.278~12.502,P<0.001)。结论血清外泌体circ_0007478表达水平与SCAD患者冠状动脉病变斑块内坏死核心体积呈正相关,提示血清外泌体circ_0007478可能作为斑块不稳定性的潜在预测因子。

Objective To investigate the correlation between serum exosomal circRNA_0007478 and the volume of necrotic core in plaque of stable coronary artery disease(SCAD).Methods A total of 103 consecutive patients with SCAD who underwent percutaneous coronary intervention(PCI)in our hospital from March 2020 to June 2022 were selected as the study subjects.The serum exosomal circ_0007478 level was detected by real-time fluorescence quantitative polymerase chain reaction.Before PCI,virtual histology intravascular ultrasound(VH-IVUS)was used to assess coronary plaque tissue components,including fibrous,fibrofatty,necrotic core,and dense calcified tissue,and to calculate the percentage of each area to the total lesion volume.Results The expression level of serum exosomal circ_0007478 in patients with SCAD was 1.20(1.04,1.42).According to the median value of serum exosomal circ_0007478,SCAD patients were divided into low expression group(≤1.20)and high expression group(>1.20).Compared with the low expression group of serum exosomal circ_0007478,the vessel volume,plaque volume,lumen volume and lesion degree in the high expression group were larger,and the percentage of necrotic core volume was higher(P<0.05).By Spearman analysis,serum exosomal circ_0007478 was positively correlated with the percentage of necrotic core volume in SCAD patients(P<0.001).In addition,the percentage of necrotic core volume was positively correlated with low density lipoprotein cholesterol(LDL-C)and neutrophil to lymphocyte ratio(NLR)(P<0.05).After controlling for LDL-C and NLR in partial correlation analysis,serum exosomal circ_0007478 was still positively correlated with percentage of necrotic core volume in SCAD patients(P<0.001).Multiple linear regression analysis showed that serum exosomal circ_0007478 was a significant predictor of necrotic core volume in patients with SCAD[β=1.567,95%CI:6.278-12.502,P<0.001].Conclusion The expression level of serum exosomal circ_0007478 was positively correlated with the necrotic core volume of coronary plaque in SCAD patients,suggesting that serum exosomal circ_0007478 may be a potential predictor of plaque instability.