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Circulating MicroRNAs and Clinical Parameters in Hypertrophic Cardiomyopathy: A Systematic Review and Correlation
Antonio da Silva Menezes Junior1,2, Henrique Lima de Oliveira1, Khissya Beatryz Alves de Lima1
1Department of Medicine, Federal University of Goiás, Goiânia, GO 74605-050, Brazil.
Insights
Circulating microRNAs (miRNAs) show significant correlations with cardiac structural and functional changes in hypertrophic cardiomyopathy (HCM). These findings suggest miRNAs may serve as valuable noninvasive biomarkers for HCM, though further research is needed.
Area of Science:
- Cardiology
- Genetics
- Biomarker Discovery
Background:
- Hypertrophic cardiomyopathy (HCM) is a genetically diverse heart condition.
- Left ventricular hypertrophy, myocardial fibrosis, and varied clinical symptoms characterize HCM.
- Circulating microRNAs (miRNAs) are potential biomarkers for cardiac remodeling, but their link to specific HCM characteristics is not well understood.
Purpose of the Study:
- To systematically review and quantify the association between circulating miRNAs and structural/functional cardiac parameters in HCM.
- To explore the potential of miRNAs as noninvasive biomarkers for HCM.
Main Methods:
- A systematic review and meta-analysis of 11 observational studies involving 633 patients.
- Searched PubMed, Embase, Scopus, and Web of Science databases.
- Analyzed correlations between miRNA expression and echocardiography, MRI, and histological data using random-effects models.
Main Results:
- Moderate-to-strong positive correlations found between specific miRNAs (miR-21, miR-29a, miR-199a-5p, miR-27a) and myocardial fibrosis, wall thickness, and left ventricular mass (r = 0.53).
- Sensitivity and meta-regression analyses confirmed result robustness.
- Moderate concerns identified in risk-of-bias assessment, mainly regarding patient selection and blinding.
Conclusions:
- Circulating miRNAs are significantly associated with cardiac structural and functional alterations in HCM.
- These miRNAs show promise as noninvasive biomarkers for HCM.
- High-quality studies are required to confirm their clinical utility.
Background:
Hypertrophic cardiomyopathy (HCM) is genetically heterogeneous and characterized by left ventricular hypertrophy, myocardial fibrosis, and diverse clinical manifestations. Although circulating microRNAs (miRNAs) are promising biomarkers of pathological cardiac remodeling, the correlation of these miRNAs with specific clinical characteristics of HCM remains unclear. Therefore, we systematically reviewed and quantified the correlation between circulating miRNAs and structural and functional cardiac parameters in HCM.
Methods:
This systematic review and meta-analysis of observational studies evaluated the association between circulating miRNA expression levels and Echocardiography, magnetic resonance imaging, and histological parameters for HCM. We comprehensively searched the PubMed, Embase, Scopus, and Web of Science databases, and extracted and transformed correlation coefficients into Fisher's Z-scores. The study was registered with PROSPERO under registration number CRD420251058653. Meta-analyses were conducted using random-effects models, and heterogeneity was assessed using the I2 statistic. Sensitivity analyses, meta-regression, and publication bias were also assessed.
Results:
A total of 11 studies comprising 633 patients were included. Pooled analysis showed moderate-to-strong positive correlations between miRNAs (miR-21, miR-29a, miR-199a-5p, and miR-27a) and myocardial fibrosis, wall thickness, and left ventricular mass (r = 0.53; 95% confidence interval 0.40-0.64; I2 = 60.1%). Sensitivity and meta-regression analyses confirmed the robustness of the results, with no significant publication bias. The risk-of-bias assessment (Quality Assessment of Diagnostic Accuracy Studies 2) revealed moderate concerns, primarily related to patient selection and index-test blinding.
Conclusion:
Circulating miRNAs were significantly correlated with structural and functional cardiac changes in HCM, supporting the potential role of these miRNAs as noninvasive biomarkers. However, further high-quality studies are needed to validate their clinical applicability.
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