Vitamin D3 deficiency, obesity, and diabetes mellitus (DM) have been shown to increase the risk of cardiovascular diseases (CVDs). However, the early detection of vascular damage in those patients is still difficult to ascertain. MicroRNAs (miRNAs) are recognized to play a critical role in initiation and pathogenesis of vascular dysfunction. Herein, we aimed to identify circulating miRNA biomarkers of vascular dysfunction as early predictors of CVDs. We have recruited 23 middle-aged Emiratis patients with the following criteria: A healthy control group with vitamin D ≥ 20ng, and BMI < 30 (C1 group = 11 individuals); A vitamin D deficiency (Vit D level ≤ 20 ng) and obese (BMI ≥ 30) group (A1 group = 9 patients); A vitamin D deficiency, obese, plus DM (A2 group = 3 patients). Arterial stiffness via pulse wave velocity (PWV) was measured and the whole transcriptome analysis with qPCR validation for miRNA in plasma samples were tested. PWV relative to age was significantly higher in A1 group 19.4 ± 4.7 m/s and A2 group 18.3 ± 1.3 m/s compared to controls 14.7 ± 2.1 m/s (p < 0.05). Similar patterns were also observed in the Augmentation pressure (AP) and Alx%. Whole RNA-Sequencing revealed miR-182-5p; miR-199a-5p; miR-193a-5p; and miR-155-5p were differentially over-expressed (logFC > 1.5) in high-risk patients for CVDs vs healthy controls. Collectively, our result indicates that four specific circulating miRNA signature, may be utilized as non-invasive, diagnostic and prognostic biomarkers for early vascular damage in patients suffering from vitamin D deficiency, obesity and DM.

A transformation in medical education is currently underway which prioritizes competency and clinical integration with basic sciences. Here we are exploring the feasibility of early echocardiography (Echo) experience as an adjunct tool for teaching heart anatomy and physiology to second year medical students.The study was conducted on 100 students in a problem‐based learning curriculum. Students were introduced to cardiac anatomy and physiology as well as the basic principles of ultrasonography before the Echo sessions. A pretest was conducted at the beginning of the Echo theoretical session, consisting of 10 questions on Echo images. The practical sessions included hands‐on experience on standardized patients with a checklist of structures that are commonly demonstrated in left parasternal and apical four chamber windows. A post‐test with the same questions was repeated after the clinical sessions.The post‐test outcome revealed a significant improvement in identifying the cardiac structures and function in comparison to the pre‐test (P value 蠄 0.0001) imageAlthough the students were very accurate in identifying heart chambers and valves without assistance, the pulmonary artery and valve in the parasternal short axis were mostly able to be identified with assistance. Furthermore 95% of students admitted that prior basic knowledge is essential for Echo images identification and 86% stated that integrating this experience is helpful in consolidating different phases of the cardiac cycle.ConclusionSpatial orientation offered by Echo with prior basic knowledge seems to provide an effective tool in consolidating medical student's understanding of heart anatomical relations and cardiac physiology.