MicroRNAs: diagnostic, prognostic and therapeutic role in heart failure—a review

Abstract

Heart failure is a leading cause of morbidity and mortality, with relevant social and economic burden on global healthcare system. Although the development of novel diagnostic tools and the advance in therapies have deeply influenced the diagnosis and treatment of this disease, improving both prognosis and life expectancy of patients, hospitalization is still high, and mortality remains considerable. MicroRNAs are small endogenous RNA molecules that post‐transcriptionally regulate gene expression in both physiological and pathological processes. In recent years, microRNA have arisen as attractive therapeutic targets in the treatment of a wide spectrum of pathologies, including heart failure. In cardiac pathology, deregulation of microRNAs expression and function is associated to adverse outcome and heart failure progression. Circulating levels of specific microRNAs have emerged as useful biomarkers for the diagnosis of heart failure or as prognostic indicators. In the present review, we summarize the state of current research on the role of miRNAs as biomarkers for diagnosis and prognosis in patients with heart failure and their use as potential therapeutic targets for this condition.

Cardiac miRNA expression during the development of chronic anthracycline-induced cardiomyopathy using an experimental rabbit model

“…The fact that miRNAs have strong and documented roles in the development of cardiovascular diseases ( Wang, 2010 ; Romaine et al, 2015 ; Barwari et al, 2016 ; Chen et al, 2017 ; Dhingra and Vasan, 2017 ; Peters et al, 2020 ; Laggerbauer and Engelhardt, 2022 ; Gargiulo et al, 2023 ) means that it is expected that miRNAs are involved in the complex pathogenesis of ANT-induced cardiotoxicity. Notably, ANT exposure has already been reported to cause differential expression in various miRNAs (reviewed in Ruggeri et al, 2018b ; Kawano and Adamcova, 2022 ; Yarmohammadi et al, 2023 ; Kuang et al, 2023 ; Chen and Xu, 2021 ; Li et al, 2022 ).…”

“…MiRNAs have a vital role in the physiological function of the heart as they influence both the electrical and mechanical properties of the myocardium. Correspondingly, distinct alterations in the miRNA profile have been associated with cardiac remodelling, fibrosis and heart failure ( Thum et al, 2007 ; Harada et al, 2014 ; Chistiakov et al, 2016 ; Chen et al, 2017 ; Dhingra and Vasan, 2017 ; Peters et al, 2020 ; Gargiulo et al, 2023 ).…”

Editors' highlight picks from 2023 in ESC heart failure

“…In a recent review article of ESC Hert Failure, Gargiulo et al summarized the currently available information on the significance of miRNAs as biomarkers and potential therapeutic targets in patients with HF. 58 Interestingly, by analysing large publicly available genetic datasets and a mouse model of HF, Liu et al highlighted miR-103-3p as a potential mediator of cardiomyocyte apoptosis and autophagy via hepatic leukaemia factor (Hlf) related signalling. 59 In another study, miR-124-3p was illustrated to interfere with cardiomyocyte survival following myocardial ischaemia/reperfusion (I/R) injury.…”

“…Short non‐coding RNA molecules, called microRNAs (miRNAs) have the potential to regulate gene expression at the post‐transcriptional level and thereby to contribute to the HF specific phenotype. In a recent review article of ESC Hert Failure, Gargiulo et al summarized the currently available information on the significance of miRNAs as biomarkers and potential therapeutic targets in patients with HF 58 . Interestingly, by analysing large publicly available genetic datasets and a mouse model of HF, Liu et al highlighted miR‐103‐3p as a potential mediator of cardiomyocyte apoptosis and autophagy via hepatic leukaemia factor (Hlf) related signalling 59 .…”

Cardiopulmonary Exercise Testing in Heart Failure

“…These microRNA levels have been studied in patients with chronic HF participating in cardiac rehabilitation. Witvrouwen et al compared plasma miRNA levels in 25 patients with heart failure enrolled in a 15-week combined aerobic and strength exercise program with 21 sedentary males to determine the effect of exercise [ 59 ]. These investigators measured miR-23a, miR-140, miR-146a, miR-191, and miR-210 levels, which are associated with pathways relevant to exercise adaptation, in both patient groups.…”