Expression Of Plasma MicroRNA-21 In Patients With Dilated Cardiomyopathy And Intervention Effect Of Kangxian-yixin Decoction On It

Objective To observe the difference of expression of plasma micro RNA-21(miR-21)in patients with dilated cardiomyopathy(DCM)and healthy volunteers as well as to explore the intervention effect of Kangxian-Yixin Decoction(KYD)on it.Based on it,we explored the possibility of miR-21 as a marker of DCM diagnosis,which provides a new strategy for the treatment of DCM with KYD.MethodsA total of 44 patients with DCM treated in Henan Hospital of traditional Chinese Medicine from December 2019 to October 2020 were randomly divided into basic treatment group and KYD group,while the KYD group was given KYD combined with conventional treatment.In addition,healthy volunteers were recruited as controls.Before and 6 months after treatment,peripheral venous blood of patients with DCM were collected respectively.The peripheral venous blood of healthy volunteers was also collected.After centrifugation,plasma layer was extracted and stored at-80℃.The changes of left ventricular end diastolic diameter(LVEDD),left ventricular short axis shortening rate(FS),left ventricular ejection fraction(LVEF),NYHA cardiac function classification,NT-pro BNP and TCM syndrome score of DCM patients before and after treatment were analyzed,and the level of plasma miR-21 was detected using q RT-PCR.Results1.Compared with the basic treatment group,LVEDD,FS and LVEF in the KYD group were significantly improved after treatment(P<0.05);NT-pro BNP levels in the two groups after treatment were significantly lower than those before treatment(P<0.05),and the reduction in the KYD group was greater than that in the basic treatment group(P<0.05).2.After treatment,the total TCM syndrome scores in the basic treatment group and KYD group were significantly lower than those before treatment(P<0.05)as well as NYHA classification was significantly improved(P<0.05).Furthermore,and the KYD group was better than the basic treatment group(P<0.05).3.Before treatment,the expression of plasma miR-21 in the basic treatment group and the KYD group was higher than that in the healthy volunteers(P<0.05).The level of plasma miR-21 in the two groups after treatment was lower than that before treatment(P<0.05),and the decrease in the KYD group was greater than that in the basic treatment group(P<0.05).4.The expression of plasma miR-21 was positively correlated with NT-pro BNP(r=0.44,P<0.05),LVEDD(r=0.73,P<0.05)and total TCM syndrome score(r=0.60,P<0.05),while negatively correlated with FS(r=-0.35,P<0.05)and LVEF(r=-0.33,P<0.05).ConclusionThe expression of plasma miR-21 in patients with DCM is higher than that in healthy volunteers,and it is positively correlated with LVEDD,NT-pro BNP and TCM syndrome score,while negatively correlated with LVEF and FS,suggesting that plasma miR-21 has a certain value in the diagnosis of DCM.The expression of plasma miR-21 was significantly decreased by KYD,suggesting that miR-21 may be a new target of KYD in the treatment of DCM.