Aim. To study the levels of circulating microRNA-21 in patients with hypertrophic cardiomyopathy (HCM) of different ages. Materials and methods. The study included 49 patients with HCM. The proportion of females was 55.1%, males 44.9%. The average age was 50 [32; 65] (from 19 to 86 years). The control group for microRNA-21 included 44 healthy individuals, respectively, matched by the age and sex with the studied patients. Patients was made in accordance with the recommendations of the European society of cardiology. Plasma microRNA expression was determined by PCR with reverse transcription and real-time detection of results. The relative level of gene expression was calculated in accordance with the standard procedure 2-Ct. Results. Septal wall thickness at end diastole has a significant negative correlation with age in patients with HCM (r=-0.56; р0.001). PWTd (posterior wall thickness at end diastole) has a significant positive correlation with age in patients with HCM (r=0.67, р0.001). The level of circulating microRNA-21 in plasma is higher in patients with HCM compared to healthy individuals (5.28 [2.64; 13.96] and 0.84 [0.55; 1.23], respectively; p0.001). Significantly higher levels of microRNA-21 were found in young patients aged from 19 to 45 years with the symptomatic course of HCM (36.76 [5.66; 42.22]) compared to patients with asymptomatic course 45 years of age (2.81 [1.45; 5.28]; p0.002) and symptomatic patients 45 years (3.88 [2.16; 8.63]; p0.002).) The calculated risk of SCD was significantly higher in young symptomatic patients with HCM (6.01 [3.64; 9.67]) compared to patients with asymptomatic course 45 years (2.41 [1.21; 3.89]; p0.001) and symptomatic patients 45 years (2.56 [1.67; 4.41]; p0.001). Conclusion. The level of circulating microRNA-21 is significantly in patients with HCM compared to control group. The maximum level of circulating microRNA-21 was detected in patients with symptomatic course of HCM at the age of 45 years.

Introduction Recently it is found that circulating miRNA-21 is associated with chronic heart failure (CHF) and ischemic heart disease. Its clinical significance in hypertrophic cardiomyopathy (HCM) and CHF with preserved left ventricular ejection fraction (LVEF) (≥50%) has to be investigated. Purpose The aim of this study was to analyze the expression of miRNA-21 in the peripheral blood of HCM patients and CHF with preserved LVEF (≥50%). Materials and methods From 2014 to 2019 years we examined 180 HCM patients. The study population consisted of 60 patients ≥19 years old (51.5 [36.2; 65.7]) with symptomatic HCM and CHF with preserved LVEF (≥50%). The diagnosis of HCM was established according to the guideline of the European society of cardiology on the diagnosis and treatment of HCM, 2014. The control group included 45 healthy donors without cardiovascular diseases and other severe pathologies, matched by age and sex with the studied group. Total RNA was extracted from plasma of patients. MiRNA-21 and reference RNA U6 cDNA was prepared based on StemLoop-technology. Expression was examined using semiquantitative RT-PCR protocol. Calculation of the relative gene expression level of miRNA-21 was done according to the standard procedure 2-ΔCt. IBM SPSS software package and Microsoft Excel 2010 were used for the statistical analysis of the collected data. Results The serum expression level of miRNA-21 in HCM patients (n=60) varied from 0.13 to 477.7 (4.92 [1.77; 13]) and was significantly higher than those in the control group (0.01 - 9.85 (0.84 [0.55; 1.23]), with statistically significant difference (p=0.001). The HCM group was divided according to CHF severity: I-II functional class (NYHA) (n=42) and III-IV functional class (NYHA) (n=18) subgroups. It was found a significant increase of expression microRNA-21 level in both subgroups HCM patients, compared with control group (p=0.001). The expression level of miRNA-21 also differed between HCM patients and CHF III-IV functional class (NYHA) vs those, who had CHF I-II functional class (NYHA) – 1.1–477.7 (13 [3.88; 41]) vs 0.1–119.4 (3.25 [1.41; 6.06]), respectively (p=0.003). In HCM patients and CHF III-IV functional class (NYHA) (n=18) the expression level of miRNA-21 positively correlated with LVEF (r=0.609; p<0.05). Conclusion HCM patients with CHF III-IV functional class (NYHA) and preserved LVEF (≥50%) demonstrated high expression level of miRNA-21. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Almazov Federal Medical Research Centre, Saint-Petersburg, Russian Federation, Pavlov University, L'va Tolstogo str. 6-8, Saint Petersburg, Russian Federation

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Aim. To analyze associations of interleukin-6 receptor gene (IL6R) polymorphism (rs2228145) with the clinical course characteristics of hypertrophic cardiomyopathy (HCM) in groups of patients with various cardiometabolic risk factorsMaterial and methods. The sample consisted of 123 patients with HCM. The age  of the included patients ranged from 18 to 91 years (59 [41; 66.5]), of whom 59 were men, 64 — women. Two age groups were identified: the first group included patients from 18 to 44 years old, the second — 45 years and older. The control group consisted of 200 people without cardiovascular diseases and other severe comorbidities.For genetic testing, DNA was isolated from peripheral blood lymphocytes. Genotyping of the IL6R gene polymorphism (rs2228145) was carried out by realtime polymerase chain reaction.Results. A significant prevalence of CC genotype of the IL6R gene polymorphism (rs2228145) was revealed in patients aged ³45 years compared with the control group, which occurred in 14,1% and 3,0% of cases, respectively (CC:AC+AA, odds ratio (OR), 0,885, 95% confidence interval (CI), 1,051-0,691, p=0,006), and insignificant prevalence of C allele in this group, which does not reach the level of significance (A:C, OR, 0,870, 95% CI, 0,427-1,02, p=0,06). The prevalence of CC genotype (15,1% vs 3,0%) and C allele (39,0% vs 29,0%) was revealed in patients with HCM in combination with hypertension (HTN) compared with the control group (CC:AS+AA, OR=0,174, 95% CI, 0,047-0,650), p=0,004); (A:C, OR=0,638, 95% CI, 0,406-1,002), p=0,05).Conclusion. The relationship between the IL6R gene polymorphism (rs2228145) and HTN in patients with HCM was confirmed. The presence of CC genotype and C allele of the rs2228145 IL6R gene polymorphism is significantly more common in patients with HCM with the disease onset ³45 years of age. The presence of CC genotype and C allele of the IL6R gene polymorphism (rs2228145) is associated with HTN in patients with HCM.

The objective was to study the clinical features of symptomatic hypertrophic cardiomyopathy (HCM) depending on the age of onset and the presence of cardiometabolic risk factors.Methods and materials. From 2014 to 2020, 250 patients were examined, 100 patients with symptomatic HCM aged 18 to 86 years were included in the study.Results. The incidence of arterial hypertension (AH), obesity, and angina syndrome was significantly higher in patients with HCM aged 45 years and older. The patients with HCM and associated obesity had greater left ventricular end-diastolic dimension and left antero-posterior size regardless of the age of onset of clinical manifestations. The young patients with HCM and associated obesity had more often AH. Patients with HCM with the disease onset ≥ 45 years of age and associated obesity had greater left ventricular posterior wall thickness, left ventricular end-diastolic dimension index. In this group of patients, pulmonary hypertension was more often diagnosed.Conclusion. Obesity and other cardiometabolic risk factors are predictors of the progressive course of HCM, which points the need for their prevention and timely correction.