目的

已有研究发现扩张型心肌病心肌有miRNAs的水平变化。本研究目的观察扩张型心肌病病人miRs血浆水平是否有变化，继而能作为扩张型心肌病的诊断标志物。

方法

我们选取45例扩张型心肌病病人和性别年龄匹配的39例健康对照人群测量血浆miR-423-5P，miR-361 -5P，miR-126，miR-155，miR-146a表达量。并且研究它们和NT-ProBNP、左室射血分数及左室内径等指标关系。

结果

扩张型心肌病组病人血浆的miR-423-5P,表达升高(P=0.003），且和NT-ProBNP正相关(r = 0.430, P = 0.003)。但ROC曲线提示曲线下面积(AUC)为0.674 (95%可信区间, 0.56 - 0.79)。miR-146a及miR-155在对照组及扩张型心肌病组无变化(p = 0.437 和p = 0.702)；miR-126及miR-361-5P在扩张型心肌病血浆也无变化(p = 0.331和p = 0.784)。

结论

扩张型心肌病病人的血浆有miR-423-5P,升高，且与NT-proBNP相关，可作为扩张型心肌病心衰诊断指标，扩张型心肌病病miR-146a,miR-155,miR-126,miR361-5P血浆水平无变化。

关键词：生物标志物扩张型心肌病微小RNA

英文摘要：

Circulating MicroRNAs in Dilated Cardiomyopathy

Abstract

Aims:Previous studies demonstrated dysregulated expression of microRNAs(miRNAs) in the myocardium of patients with dilated cardiomyopathy (DCM). This study investigated levels of miRNAs in the circulation of DCM patients, and the value of miRNAs as biomarkers for DCM.

Methods: In 45 DCM patients and 39 age- and sex-matched controls, circulating miR-423-5p, miR-126, miR-361-5p, miR-155, and miR-146a concentrations were measured and correlated to cardiac functional parameters, including left ventricular ejection fraction (LVEF) and N-terminal pro-brain natriuretic peptide (NT-proBNP).

Results:  Plasma levels of miR-126 and miR-361-5P did not differ between the DCM and control groups (p = 0.331 and p = 0.784, respectively). Plasma levels of the immunity associated miRNAs, miR-146a and miR-155, did not differ between the DCM and control groups (p = 0.437 and p = 0.702, respectively). Levels of circulating miR-423-5p were significantly greater in the DCM group (P = 0.003). Further, there was a positive correlation between plasma levels of miR-423-5p and NT-proBNP (r = 0.430, P = 0.003). miR-423-5p distinguished DCM cases from controls with an area under the curve (AUC) receiver operating characteristic (ROC) curve of 0.674 (95% confidence interval, 0.555 to 0.793). By using a threshold miR-423-5PLnRQ of 4.017 as the lower limit for patients with DCM, there was a sensitivity of 87% and a specificity of 49% for patients with DCM patients.

Conclusions:Patients with DCM have elevated plasma miR-423-5p levels. The plasma concentration of miR-423-5p was positively correlated with the level of NT-proBNP. Circulating levels of miR-423-5p could be served as a diagnostic biomarker for heart failure in patients with DCM. Plasma levels of immunity-associated miR-146a, -155, and -126 were not significantly different between DCM and control groups.

Key words: Biomarkers; Dilated cardiomyopathy; Heart failure; MicroRNA