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Circulating microRNAs in predicting fibrosis in hypertrophic cardiomyopathy: A systematic review
Maneeth Mylavarapu1, Lakshmi Sai Meghana Kodali2, Roopeessh Vempati3
1Public Health, Adelphi University, Garden City, NY 11530, United States.
Insights
Specific circulating microRNAs (miRNAs) show promise as noninvasive biomarkers for detecting myocardial fibrosis in hypertrophic cardiomyopathy (HCM). Elevated levels of miR-21 and miR-29a correlate with fibrosis extent in HCM patients.
Area of Science:
- Biomarkers
- Cardiovascular Research
- Molecular Diagnostics
Background:
- Hypertrophic cardiomyopathy (HCM) involves left ventricular hypertrophy and fibrosis, leading to adverse outcomes.
- Cardiac magnetic resonance (CMR) detects fibrosis, but circulating microRNAs (miRNAs) offer a stable, noninvasive biomarker alternative.
Purpose of the Study:
- To investigate circulating miRNAs as potential biomarkers for myocardial fibrosis in HCM patients.
- To identify specific miRNAs associated with fibrosis in HCM.
Main Methods:
- Systematic literature review of studies from 2014-2024 on miRNAs and HCM fibrosis.
- Included studies measuring miRNA expression in HCM patients' blood and assessing fibrosis via imaging (primarily CMR).
- Extracted data on population, methods, and correlations between miRNA levels and fibrosis.
Main Results:
- Seven studies (365 HCM patients) identified miR-21, miR-29a, miR-133, miR-4454, and miR-221 as dysregulated markers.
- Elevated miR-21 and miR-29a levels correlated with increased fibrosis on CMR.
- miR-29a consistently linked to both fibrosis and hypertrophy in HCM.
Conclusions:
- Circulating miRNAs, especially miR-21, miR-29a, and miR-221, are promising biomarkers for HCM-related myocardial fibrosis.
- Further research is needed to validate these findings and explore clinical applications of miRNA diagnostics in HCM.
Background:
Hypertrophic cardiomyopathy (HCM) is characterized by left ventricular hypertrophy and interstitial fibrosis, which contribute to adverse outcomes such as heart failure and sudden cardiac death. While cardiac magnetic resonance (CMR) imaging is commonly used to detect myocardial fibrosis, circulating microRNAs (miRNAs) have emerged as promising noninvasive biomarkers for this condition due to their stability in blood plasma and resistance to pH and temperature variance.
Aim:
To explore the role of specific circulating miRNAs in identifying myocardial fibrosis in patients with HCM.
Methods:
Using PubMed/MEDLINE and Google Scholar, we reviewed studies from 2014 to 2024 examining the link between circulating miRNAs and myocardial fibrosis in HCM. We included studies measuring miRNA expression in blood samples from HCM patients and assessing fibrosis via imaging, mostly CMR. Data extraction concentrated on the population, methodology, and findings related to the correlation between miRNA levels and fibrosis.
Results:
Seven studies involving 365 HCM patients with a mean age of 49.37 ± 10.5 years, 116 (31.78%) females, and one animal study identified miR-21, miR-29a, miR-133, miR-4454, and miR-221 as frequently dysregulated markers associated with fibrosis. Elevated levels of miR-21 and miR-29a correlated with more extensive fibrosis, as assessed by late gadolinium enhancement in CMR imaging, with miR-29a consistently linked to both fibrosis and hypertrophy across the studies.
Conclusion:
Circulating miRNAs, particularly miR-21, miR-29a, and miR-221, show significant potential as biomarkers for myocardial fibrosis in HCM. Further research should validate these findings and investigate the clinical application of miRNA-based diagnostics in HCM.
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