Biomarker Discovered for Pregnancy-Related Heart Disease

A molecule has been identified that can serve as a biomarker for peripartum cardiomyopathy that occurs in pregnant women during the last month or in the months following their pregnancy.

The molecule is a micro-ribonucleic acid (miRNA) which is induced by the nursing hormone prolactin and detection in the blood, protected from endogenous ribonuclease (RNase) activity by exosomes, has emerged as a promising diagnostic tool.

Scientists at the University of Liege (Belgium) obtained plasma samples from 38 patients with peripartum cardiomyopathy (PPCM) at their first presentation and from18 healthy nursing women, from five age-matched healthy controls, from 30 patients with heart failure due to dilated cardiomyopathy (DCM), and from patients with PPCM receiving bromocriptine.

The investigators found the expression miRNA miR-146a was induced by the nursing hormone prolactin. MiR-146a expression promoted vascular damage and was increased in a mouse model of PPCM. Conversely, loss of miR-146a in mice prevented PPCM. Plasma levels of miR-146a were significantly higher in patients with acute PPCM compared with healthy postpartum controls. Levels of miR-146a were not significantly different between healthy postpartum controls and healthy nonpregnant women. Compared with 30 patients with a similar degree of heart failure due to DCM and with no history of PPCM, miR-146a levels were significantly higher in the PPCM group.

The results of this study indicate that miR-146a mediates antiangiogenic effects of 16-kDa N-terminal prolactin fragment (16K PRL) in endothelial cells and the slowing of metabolism in cardiomyocytes. In addition, this microRNA may serve as a highly specific blood biomarker useful for diagnosis and risk stratification of patients with peripartum heart failure and appears to be a specific biomarker of PPCM. The study was published on April 24, 2013, in the Journal of Clinical Investigation.

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University of Liege