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. 2025 Feb 19;25(1):114.
doi: 10.1186/s12872-024-04465-y.

The association of serum hsa-miR-21-5p expression with the severity and prognosis of heart failure with reduced ejection fraction

Lingmiao Wang  1 , Ailin Guo  2 , Shuang Liang  3 , Lingling Yu  3 , Bai Shen  4 , Zhihang Huang  5
Affiliations

The association of serum hsa-miR-21-5p expression with the severity and prognosis of heart failure with reduced ejection fraction

Lingmiao Wang et al. BMC Cardiovasc Disord. .

Abstract

Background: Heart failure poses a huge burden on the global population, and approximately 50% cases have reduced ejection fraction, namely, heart failure with reduced ejection fraction (HFrEF). The research was supposed to explore the relationship between serum hsa-miR-21-5p expression and the severity/prognosis of HFrEF.

Methods: A retrospective analysis was conducted on 105 HFrEF patients and 86 healthy volunteers. RT-qPCR was used for the detection of serum hsa-miR-21-5p levels. Whether serum hsa-miR-21-5p expression correlated to cardiac function and hemodynamic indicators was evaluated using Spearman correlation analysis. Receiver operating characteristic and Kaplan-Meier analyses were implemented to evaluate the predictive significance of serum hsa-miR-21-5p for cardiovascular re-hospitalization and cardiovascular deaths in HFrEF patients. Independent risk factors for cardiovascular deaths were analyzed based on COX regression.

Results: Higher heart rate, fasting plasma glucose (FPG), N-terminal pro-brain natriuretic peptide (NT-pro-BNP), left atrial diameter (LAD), systolic pulmonary artery pressure (sPAP), pulmonary vascular resistance (PVR), pulmonary capillary wedge pressure (PCWP), and hsa-miR-21-5p as well as lower left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were detected in the HFrEF patients than in the controls. Hsa-miR-21-5p expression increased in HFrEF patients with the increase of NYHA grade. Serum hsa-miR-21-5p expression in HFrEF patients was positively relevant to NT-pro-BNP, LAD, sPAP, PVR, and PCWP but negatively related to LVEF and LVFS. Serum hsa-miR-21-5p had a high predictive value for cardiovascular re-hospitalization and cardiovascular deaths in HFrEF patients. High hsa-miR-21-5p expression was an independent dangerous factor for cardiovascular deaths.

Conclusion: Collectively, hsa-miR-21-5p expression in HFrEF patients is correlated with disease severity and the risk of cardiovascular re-hospitalization and cardiovascular deaths in HFrEF patients, indicating a new direction for evaluating the disease situation and prognosis.

Keywords: Cardiac function; Cardiovascular deaths; Cardiovascular re-hospitalization; Disease severity; Heart failure with reduced ejection fraction; Hsa-miR-21-5p; NYHA grade; Prognosis.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study followed the ethical guidelines of the World Medical Association Declaration of Helsinki and relevant norms and regulations for clinical research and complied with the EQUATOR network guidelines. This study was approved by the Academic Ethics Committee of Xiang’an Hospital of Xiamen University, School of Medicine, Xiamen University. (Approval number: 2024-114-01). Informed consent to participate was obtained from all of the participants in the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Serum hsa-miR-21-5p expression is high in HFrEF patients. The Kolmogorov-Smirnov test is used for normality test, and non-normally distributed measurement data are represented by median values (minimum, maximum) and compared by the Mann-Whitney U test. ***p < 0.001
Fig. 2
Fig. 2
Serum hsa-miR-21-5p expression in patients with HFrEF of different NYHA grades. The Shapiro-Wilk test is used for normality test, and non-normally distributed measurement data are represented by the median values (minimum, maximum) and compared using the Kruskal-Wallis rank sum test, with Dunn’s multiple comparisons for post hoc test. ***p < 0.001
Fig. 3
Fig. 3
The correlations of serum hsa-miR-21-5p expression with cardiac function and hemodynamic indicators in HFrEF patients. (A-G) Spearman correlation analysis on serum hsa-miR-21-5p expression and cardiac function indicators (cTnI, CK-MB, NT-pro-BNP, LAD, LVEF, LVFS) as well as hemodynamic indicators (sPAP, PVR, PCWP). r is the correlation coefficient
Fig. 4
Fig. 4
The predictive value of serum hsa-miR-21-5p expression for cardiovascular re-hospitalization and cardiovascular deaths in HFrEF patients. The Kolmogorov-Smirnov test is employed for normality test, and non-normally distributed measurement data are represented by median values (minimum, maximum) and compared by the Mann-Whitney U test. The predictive value of serum hsa-miR-21-5p expression for cardiovascular re-hospitalization and cardiovascular deaths in HFrEF patients is evaluated using ROC analysis
Fig. 5
Fig. 5
The impact of serum hsa-miR-21-5p expression on the risk of cardiovascular re-hospitalization and cardiovascular deaths in HFrEF patients. The Kaplan-Meier analysis is utilized to investigate the influence of different serum hsa-miR-21-5p expression on the risk of cardiovascular re-hospitalization and cardiovascular deaths in HFrEF patients
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