Aim: To evaluate the diagnostic significance of a microRNA panel (-21, -29a, -133a) in patients with hypertrophic cardiomyopathy (HCM) by comparing their expression levels to a group with moderate arterial hypertension (comparison group).
Material and methods: A comparative study was conducted involving 80 individuals: 40 patients with confirmed HCM and 40 sex- and age-matched controls (22 men, 18 women, mean age 55.3±13.3 years). All participants underwent a comprehensive examination at the cardiology department, including electrocardiography (ECG), echocardiography with full assessment of intracardiac hemodynamic parameters, Holter ECG monitoring, and laboratory tests. For molecular biological analysis, plasma expression levels of circulating microRNAs (-21, -29a, -133a) were determined for all participants using real-time polymerase chain reaction.
Results: Circulating microRNA levels differed significantly between patients with HCM and the comparison group. The analysis showed a significant increase in the microRNA-21 expression (4.07 vs. 2.03; p<0.001) and significant decreases in microRNA-29a (0.24 vs. 1.83; p<0.001) and microRNA-133a (0.02 vs. 6.34; p<0.001). ROC analysis demonstrated a high discriminatory ability of the studied microRNAs: microRNA-21 (AUC=0.887, sensitivity 89.7%, specificity 84.4%); microRNA-29a (AUC=0.884, sensitivity 92.3%, specificity 87.5%).
Conclusion: Increased expression of microRNA-21 and decreased expression of microRNA-29a are associated with myocardial fibrosis, while marked suppression of microRNA-133a reflects hypertrophic remodeling. These findings suggest that this microRNA panel holds promise as potential auxiliary markers for HCM, though clinical significance requires validation in larger, prospective studies.