Department of Clinical Chemistry and Laboratory Diagnostics, Medical University of Warsaw, Warsaw, Poland.
Department of Clinical Chemistry and Laboratory Diagnostics, Medical University of Warsaw, Warsaw, Poland
Pol Arch Intern Med. 2020 Jan 31;130(1):59-65. doi: 10.20452/pamw.15137. Epub 2020 Jan 14.
Acute myocardial infarction (AMI) induces unfavorable left ventricular remodeling (LVR), a complex process that involves molecular, cellular, and geometric alterations leading to important changes in heart structure and function. Heart failure (HF) is a frequent complication of AMI, and it remains a serious clinical, epidemiological, and economic challenge. Despite advances in the therapy and management of HF, many patients still suffer from severe symptoms. The underlying molecular mechanisms of the post‑AMI LVR are not yet fully understood. Numerous studies have indicated that dysregulation in the expression of microRNA (miRNA) molecules leads to changes in several pathological processes in the heart, which are associated with post‑AMI transition from cardiac hypertrophy to HF. In this review, we summarize the current knowledge on the role of miRNAs in the regulation of basic processes, such as excessive myocardial fibrosis, pathological cardiomyocyte hypertrophy, and myocardial cell apoptosis. Moreover, the significance of circulating miRNAs as noninvasive prognostic biomarkers in the prediction of LVR and HF after AMI has also been discussed. In conclusion, miR‑29 family members (miR‑29a and miR‑29b), miR‑150, and miR‑30a‑5p represent different groups of miRNAs, but all of them are involved in the regulation of the fundamental processes associated with post‑AMI left ventricular dysfunction and HF. Furthermore, these miRNA molecules may serve as a potential therapeutic target during disease progression.
急性心肌梗死（AMI）可导致不利的左心室重构（LVR），这是一个涉及分子、细胞和几何改变的复杂过程，可导致心脏结构和功能的重要变化。心力衰竭（HF）是 AMI 的常见并发症，它仍然是一个严重的临床、流行病学和经济挑战。尽管 HF 的治疗和管理取得了进展，但许多患者仍存在严重的症状。AMI 后 LVR 的潜在分子机制尚未完全阐明。许多研究表明，miRNA 分子表达的失调导致心脏中几种病理过程的改变，这些改变与 AMI 后从心肌肥厚向 HF 的转变有关。在这篇综述中，我们总结了 miRNA 在调节过度心肌纤维化、病理性心肌细胞肥大和心肌细胞凋亡等基本过程中的作用的最新知识。此外，还讨论了循环 miRNA 作为预测 AMI 后 LVR 和 HF 的非侵入性预后生物标志物的意义。总之，miR-29 家族成员（miR-29a 和 miR-29b）、miR-150 和 miR-30a-5p 代表不同的 miRNA 群体，但它们都参与了与 AMI 后左心室功能障碍和 HF 相关的基本过程的调节。此外，这些 miRNA 分子可能在疾病进展过程中作为潜在的治疗靶点。
