ASSESSMENT OF MICRORNA-21 GENE EXPRESSION LEVELS IN RELATION WITH THE DETERIORATION OF LEFT VENTRICULAR STRAIN IN HYPERTENSIVE PATIENTS

Abstract

Objective: MicroRNAs (miRs) modulate cardiovascular development and disease by post-transcriptional gene expression regulation and thus they are emerging as potential biomarkers and promising therapeutic targets in cardiovascular disease. miR-21 is found to play important roles in vascular smooth muscle cell proliferation and apoptosis, cardiac cell growth and death, and cardiac fibroblast functions.. We evaluated miR-21 gene expression levels in peripheral blood mononuclear cells in patients with essential hypertension in relation to left ventricular global longitudinal peak strain (GLPS). Design and method: We included 50 patients with newly diagnosed essential hypertension stage 1 and 2 (31 men, mean age 69.5 ± 11.8 years, mean systolic blood pressure (SBP) 167 ± 19 mmHg and mean diastolic blood pressure (DBP) 107 ± 11 mmHg). All patients underwent a serial assessment with standard conventional transthoracic and a two-dimensional speckle tracking echocardiography at baseline and at 24 months follow-up. miR-21 gene expression levels in peripheral blood mononuclear cells were quantified by real-time reverse transcription polymerase chain reaction. Results: Systolic and diastolic blood pressure was significantly reduced in the 12 months follow up under antihypertensive medication (SBP: from 167 ± 19 mmHg to 147 ± 15 mmHg and DBP: from 107 ± 11 mmHg to 95 ± 15 mmHg, p < 0.05 for both). GLPS showed a significant reduction during the 24 months follow-up (from −18.3 ± −4.9 % at baseline to −16.5 ± −6.9%, p = 0.04). miR-21 gene expression levels at baseline revealed a significant positive correlation with the reduction of GLPS (r = 0.52, p < 0.001). This correlation was independent of the patients’ clinical parameters Conclusions: Our data reveal that miR-21 might have a prognostic value in the deterioration of left ventricular GLPS in essential hypertension. In addition, it may be involved in the pathophysiology of in hypertensive heart disease and may be a promising therapeutic target.