| BACKGROUND: Heart failure is considered as the terminal phase of heartdiseases, with long-term hospitalization，high treatment cost and alarming mortality.Therefore，its early diagnosis，proper treatment and evaluation are helpful to reducethe hospitalization period, the cost of treatment and the mortality. However, theconventional physical examinations and heart function tests are often not sufficient todraw an accurate diagnosis. In recent years, in addition to a comprehensive evaluationof heart failure history, symptoms, physical examination, laboratory examinations，thesignificance of measuring plasma BNP and NT pro-BNP levels has been clinicallyrecognized in heart failure diagnosis and evaluation. However, the value of BNP orNT pro-BNP is always limited in the patients who also suffer from pulmonaryembolism, renal insufficiency, infection, and liver cirrhosis. In these cases, multiplebiological indicators may be helpful to improve the diagnostic rate, and be beneficialto judge the individual’s condition with different clinical manifestations.MicroRNA are endogenous non-coding small RNAs, as long as about18-23nucleotide sequence. They can combine with the mRNA3’untranslated region toinhibit the process of transcription and translation. Researchers have confirmed thatmiRNAs are associated with embryonic development, metabolism, cell proliferation,differentiation, and apoptosis, as well as some pathologic conditions, such as tumor.Moreover，they also have an important role in the pathophysiology of cardiovasculardiseases. Studies have shown that miRNAs present in the tissue cells, and are relatedwith cardiac development, cell hypertrophy, fibrosis. Meanwhile, the detection ofsome miRNAs in the peripheral circulation makes them the sensitive and specificbiomarkers for the disease state. In the pathogenesis of heart failure, as cardiac overload in long-term state, withneurohormonal factors and other growth-promoting substances affected, there may beabnormal myocardial cell apoptosis and necrosis, myocardial hypertrophy, increasedextracellular matrix, myocardial tissue fibrosis and other pathological changes. Avariety of changes in the expression of miRNAs in heart failure models, however,studies on the relationship between plasma miRNAs levels and heart failure is stillrare.Objective：Research on the role of miRNAs in the pathophysiology of heartfailure. Since microRNA-210(miR-210) expression induced by hypoxia, whoseplasma levels may reflect cardiac pump function according to the lack of oxygen inthe surrounding tissues. In this study, we measure plasma levels of miR-210indifferent causes of heart failure with and without atrial fibrillation, and comparemiR-210plasma levels of with different NYHAs, assess its relevance with BNP andLVEF, to evaluate the significance of miR-210plasma levels in systolic heart failurein order to determine the extent and prognosis of heart failure and to guide treatmentmore accurately.Methods: Subjects: Patients were diagnosed and treated in hospital fromNovember,2013to January,2014. Systolic heart failure (HF-REF) patients with atotal of50cases, in which24cases of atrial fibrillation;18cases of ischemic heartdisease,10cases of hypertensive heart disease,10cases of rheumatic heart disease,12cases of dilated cardiomyopathy. Moreover, grouping performed according to theNew York heart Association (NYHA) functional class. Select44patients of NYHAⅠas controls,13cases of which are atrial fibrillation. We measure plasma levels ofmiR-210in different causes of heart failure with and without atrial fibrillation, andcompare miR-210plasma levels of with different NYHAs, assess its relevance withBNP and LVEF in order to investigate the value of plasma levels of miR-210in theevaluation and prognosis of heart failure. Using SPSS19.0statistical software for analysis of experimental data normality test and homogeneity of variance test, if theymeet the normal distribution or by converting a normal distribution were expressed asmean±standard deviation (x±s). Using two independent samples t test was used forcomparison between two groups, one-way ANOVA conducted among groups.Between multiple pairwise comparisons using the least significant difference (LSD) ttest, using a simple linear correlation analysis of the correlation analysis between thedifferent indicators. Set test performance a=0.05, with P <0.05was consideredstatistically significant.Results: Plasma levels of miR-210in patients with heart failure group washigher (P <0.01). Heart failure with atrial fibrillation compared with the controlcombined with atrial fibrillation, the plasma levels of miR-210were significantlyhigher (P <0.01). Heart failure with atrial fibrillation compared with single heartfailure group, and control group with atrial fibrillation compared with single controlgroup, the plasma miR-210levels increased, but the difference was not statisticallysignificant (P>0.05). MiR-210levels in NYHA III, IV group higher than the controland NYHA II groups (P <0.05); NYHA IV group compared with NYHA III group，NYHA II group compared with the control group，no significant difference wasdetected in miR-210levels(p>0.05). Plasma levels of miR-210in patients of dilatedcardiomyopathy, ischemic heart disease, hypertensive heart disease, valvular heartdisease show no significant difference (P>0.05). Linear regression analysis showedthat in patients with systolic heart failure, plasma miR-210levels were positivelycorrelated with BNP, and negatively correlated with LVEF，which suggest miR-210plasma levels are related to the severity of heart failure.Conclusion:1. Plasma miR-210expression levels can be used as an evaluation indicator ofdisease severity in patients with systolic heart failure;2. The expression level of miR-210in plasma has good correlation with BNP and LVEF, indicating plasma levels of miR-210may be used as a new biomarker toevaluate the condition and prognosis of heart failure. |
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