Diagnostic value of circulating microRNA‐19b in heart failure

Abstract

Objective: For differentiating heart failure (HF) with preserved ejection fraction (HFpEF) from HF with reduced EF (HFrEF), N-terminal prohormone brain natriuretic peptide (NT-proBNP) is less accurate. Decreased expression of microRNA-19b (miR-19b) is associated with increased cardiac-fibrosis. We aim to evaluate the value of miR-19b in diagnosing HFrEF patients. Method: We included 200 HF patients and 100 healthy controls. Intergroup comparisons of miR-19b were made and correlation between miR-19b and NT-proBNP was analysed. Diagnostic values of NT-proBNP and miR-19b for HF patients versus controls and HFrEF versus HFpEF were obtained by ROC analysis and described by area under curve (AUC), sensitivity and specificity. Results: HFrEF patients (0.87, 95% CI 0.37-1.45) had significantly lower miR-19b level than HFpEF group (1.32, 95% CI 0.63-2.51) and the controls (1.82, 95% CI 0.37-1.45) (both P < .001). There was a remarkable negative correlation between miR-19b and NT-proBNP (P < .001). The additional use of miR-19b did not improve the accuracy of NT-proBNP alone in diagnosing HF patients from the controls (both AUC = 0.98, 95%CI 0.97-0.99). However, as for distinguishing the HFpEF from HFrEF, miR-19b and NT-proBNP yielded a significantly higher AUC than NT-proBNP alone (0.85, 95% CI 0.80-0.90 vs. 0.66, 95% CI 0.58-0.74) (P < .001), and the sensitivity for diagnosing HFrEF was raised from 58% to 77% and the specificity from 75% to 79%. Conclusions: On top of NT-proBNP, miR-19b added the value in diagnosing HFrEF. But in view of satisfactory accuracy of NT-proBNP in predicting HF from the healthy volunteers, miR-19b did not provide incremental value.

Catheter ablation of atrial fibrillation in patients with heart failure and preserved ejection fraction: A meta‐analysis

“… 17 , 28 However, our analysis identified similar procedure and fluoroscopic time periods for patients with HFpEF compared with those without HF, which was in agreement with previous studies. 17 , 18 The reasons may be as follows: (a) according to the baseline data of included studies, patients with HFpEF did not experience significant enlargement of the LA when compared with patients without HF; (b) patients with HFpEF are less likely to develop irreversible and severe fibrosis in the LA 29 ; (c) patients with HFpEF are not accompanied by a significant decrease in LVEF and fewer emergencies that occurred during procedure. The aforementioned factors may contribute to the nonsignificant differences in the procedure and fluoroscopic time observed for patients with HFpEF and without HF.…”

The microRNA Expression Profiling in Heart Failure: A Systematic Review and Meta-Analysis

“…Over the past years, miRNAs have be observed to play key roles in the physiopathology of HF ( 56 , 72 ), and there is increasing number of articles reporting on the differentially expressed miRNAs in HF ( 21 , 29 , 35 ). The identification of the dysregulated miRNAs may lead to the novel discovery to monitor the progression of HF.…”

“…The dysregulated miRNAs (miR-19b, miR-129-5p, miR-221-3p, miR-208a, etc.) may provide non-invasive biomarkers for the diagnosis and prognosis of HF ( 29 , 36 , 62 , 64 ). Therefore, the practicable detection methods are essential to ensure the accuracy and precision of miRNAs ( 86 ).…”

“…MiRNAs change in certain diseases, especially circulating miRNAs due to their stability makes them possible biomarkers in HF ( 27 ). Previous studies have reported that the dysregulated miRNAs can serve as the potential diagnostic biomarker in HF ( 16 , 28 , 29 ). Additionally, miRNA-19b, miR-21, miR-423-5p, and miR-92b-5p were observed to be promising biomarker for HF ( 16 , 29 – 31 ).…”

“…Previous studies have reported that the dysregulated miRNAs can serve as the potential diagnostic biomarker in HF ( 16 , 28 , 29 ). Additionally, miRNA-19b, miR-21, miR-423-5p, and miR-92b-5p were observed to be promising biomarker for HF ( 16 , 29 – 31 ). Given the pathogenic role of miRNAs in HF, the present study explored an association between miRNAs expression signatures and HF.…”