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The following is a summary of “Association of serum hsa-miR-21-5p expression with the severity and prognosis of heart failure with reduced ejection fraction,” published in the February 2025 issue of the BMC Cardiovascular Disorders by Wang et al.

Heart failure remains a significant global health burden, with approximately half of all cases classified as heart failure with reduced ejection fraction (HFrEF). Identifying reliable biomarkers for disease severity and prognosis is crucial for improving patient outcomes. This study aimed to investigate the relationship between serum hsa-miR-21-5p expression and the severity, progression, and prognosis of HFrEF. A retrospective analysis was conducted on 105 patients diagnosed with HFrEF and 86 age- and sex-matched healthy controls. Serum hsa-miR-21-5p levels were measured using real-time quantitative polymerase chain reaction (RT-qPCR). Correlations between serum hsa-miR-21-5p expression and key clinical parameters, including cardiac function and hemodynamic indicators, were assessed using Spearman correlation analysis. 

Additionally, receiver operating characteristic (ROC) and Kaplan-Meier survival analyses were performed to determine the predictive value of hsa-miR-21-5p for cardiovascular rehospitalization and mortality in patients with HFrEF. Cox regression analysis was used to identify independent risk factors associated with cardiovascular mortality. Results demonstrated that patients with HFrEF exhibited significantly higher heart rate, fasting plasma glucose (FPG), N-terminal pro-brain natriuretic peptide (NT-proBNP), left atrial diameter (LAD), systolic pulmonary artery pressure (sPAP), pulmonary vascular resistance (PVR), pulmonary capillary wedge pressure (PCWP), and hsa-miR-21-5p levels compared to controls (all p < 0.05). Conversely, left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were markedly reduced in patients with HFrEF. 

Further analysis revealed a positive correlation between hsa-miR-21-5p expression and NT-proBNP, LAD, sPAP, PVR, and PCWP, while a negative correlation was observed with LVEF and LVFS (all p < 0.05). ROC analysis indicated that hsa-miR-21-5p exhibited high predictive accuracy for cardiovascular rehospitalization and mortality. Kaplan-Meier analysis revealed that patients with elevated hsa-miR-21-5p levels had significantly higher risks of adverse cardiovascular outcomes. Moreover, Cox regression analysis identified high hsa-miR-21-5p expression as an independent risk factor for cardiovascular mortality (hazard ratio >1.0, p < 0.05). These findings suggest that serum hsa-miR-21-5p is closely associated with the severity and prognosis of HFrEF, highlighting its potential as a novel biomarker for risk stratification and disease monitoring. 

The ability of hsa-miR-21-5p to predict cardiovascular events suggests its potential utility in guiding therapeutic interventions and improving clinical management in patients with HFrEF. Future studies should further explore the mechanistic role of hsa-miR-21-5p in HFrEF pathophysiology and evaluate its potential as a therapeutic target for mitigating heart failure progression.

Source: bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-024-04465-y