Department of Research, IRCCS-ISMETT, Palermo, Italy.
Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy.
ESC Heart Fail. 2024 Feb;11(1):155-166. doi: 10.1002/ehf2.14546. Epub 2023 Oct 21.
MicroRNAs play a role in pathogenic mechanisms leading to heart failure. We measured a panel of 754 miRNAs in the myocardial tissue and in the serum of patients with heart failure with reduced ejection fraction due to dilatative idiopathic cardiomyopathy (DCM, N = 10) or ischaemic cardiomyopathy (N = 3), referred to left ventricular assist device implant. We aim to identify circulating miRNAs with high tissue co-expression, significantly associated to echocardiographic and haemodynamic measures.
We have measured a panel of 754 miRNAs in the myocardial tissue [left ventricular (LV) apex] and in the serum obtained at the same time in a well selected study population of end-stage heart failure with reduced ejection fraction due to either DCM or ischaemic cardiomyopathy, referred to continuous flow left ventricular assist device implant. We observed moderate agreement for miR-30d, miR-126-3p, and miR-483-3p. MiR-30d was correlated to LV systolic as well as diastolic volumes (r = 0.78, P = 0.001 and r = 0.80, P = 0.005, respectively), while miR-126-3p was associated to mPAP and PCWP (r = -0.79, P = 0.007 and r = -0.80, P = 0.005, respectively). Finally, serum miR-483-3p had an association with right ventricular end diastolic diameter (r = -0.73, P = 0.02) and central venous pressure (CVP) (r - 0.68 p 0.03).
In patients with DCM, few miRNAs are co-expressed in serum and tissue: They are related to LV remodelling (miR-30d), post-capillary pulmonary artery pressure (miR-126-3p), and right ventricular remodelling/filling pressures (miR-483-3p). Further studies are needed to confirm their role in diagnosis, prognosis or as therapeutic targets in heart failure with reduced ejection fraction.
微小 RNA 在导致心力衰竭的致病机制中发挥作用。我们测量了一组 754 种微小 RNA，这些微小 RNA 存在于因扩张型特发性心肌病（DCM，N=10）或缺血性心肌病（N=3）导致射血分数降低的心力衰竭患者的心肌组织和血清中，并接受了左心室辅助装置植入。我们旨在确定具有高组织共表达、与超声心动图和血液动力学测量显著相关的循环微小 RNA。
我们在一个经过精心挑选的射血分数降低的终末期心力衰竭患者研究人群中，测量了一组 754 种微小 RNA，这些患者因 DCM 或缺血性心肌病导致射血分数降低，需要接受连续流动左心室辅助装置植入。我们观察到微小 RNA-30d、微小 RNA-126-3p 和微小 RNA-483-3p 的一致性中等。微小 RNA-30d 与左心室收缩和舒张容积相关（r=0.78，P=0.001 和 r=0.80，P=0.005），而微小 RNA-126-3p 与 mPAP 和 PCWP 相关（r=-0.79，P=0.007 和 r=-0.80，P=0.005）。最后，血清微小 RNA-483-3p 与右心室舒张末期直径（r=-0.73，P=0.02）和中心静脉压（CVP）（r=-0.68，P=0.03）相关。
在 DCM 患者中，少数微小 RNA 在血清和组织中共同表达：它们与左心室重构（微小 RNA-30d）、毛细血管后肺动脉压（微小 RNA-126-3p）和右心室重构/充盈压（微小 RNA-483-3p）相关。需要进一步研究以确认它们在射血分数降低的心力衰竭中的诊断、预后或作为治疗靶点的作用。
