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.

Keywords: Biomarkers; Heart failure; Therapy; microRNA.

Figure 1

Schematic representation of miRNA biogenesis. miRNAs are transcribed by RNA polymerase II (Pol II) as long unstructured precursors (pri‐miRNA) that undergo nuclear processing by DROSHA‐DGCR8 to produce a pre‐miRNA. Pre‐miRNAs are then exported to the cytoplasm, where they are further cleaved by the endonuclease DICER and its cofactors. This processing produces a mature miRNA duplex. One strand of the mature miRNA is then loaded onto the RISC assembly, leading to translational repression or target mRNA degradation.