Abstract
BACKGROUND: Heart failure (HF) is a fast-growing public health concern that is linked to substantial morbidity and mortality as well as a poor quality of life. There is no specific biomarker that can be used to detect early HF with preserved ejection fraction (EF). MicroRNAs (miRs) are known to be involved in the development of HF. AIM: To investigate the plasma level of miR-19b, miR-21, and miR-208a and their relevance in early diagnosis of HF. SUBJECTS AND METHODS: In this study, 120 participants were divided into four groups: 30 controls in Group I, 30 HF patients with preserved EF in Group II, 30 HF patients with mildly reduced EF (HFmrEF) in Group III, and 30 HF patients with reduced EF (HFrEF) in Group IV. Real-time PCR was used to examine the expression levels of miR-19b, miR-21, and miR-208a, and ELISA was used to assess the NT-proBNP level. RESULTS: Compared to controls, HF patients' groups exhibited a substantial sequential rise in miR-21 and miR-208a expression (p < 0.001). However, HF patients had considerably lower levels of miR-19b expression compared to controls (p < 0.001). The cutoff value of miR-19b to discriminate HFmrEF from HFpEF was 11.2 (93.3% sensitivity, 86.7% specificity) (p < 0.001). In contrast, miR-21 had a cutoff value of 5.5 (70% sensitivity and 76.7% specificity), and miR-208a had a cutoff point of > 10.3 (93.3% sensitivity and 93.3% specificity). CONCLUSION: MiR-19b, miR-208a and miR-21 could be useful biomarkers with high sensitivity and specificity for early detection of HF and in discrimination between HFmrEF and HFpEF.