Mylavarapu M, Kodali LSM, Vempati R, Nagarajan JS, Vyas A, Desai R. Circulating microRNAs in predicting fibrosis in hypertrophic cardiomyopathy: A systematic review. World J Cardiol 2025; 17(5): 106123 [DOI: 10.4330/wjc.v17.i5.106123]
Corresponding Author of This Article
Rupak Desai, MBBS, Outcomes Research, Independent Researcher, Scottdale, Atlanta, GA 30079, United States. drrupakdesai@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. May 26, 2025; 17(5): 106123 Published online May 26, 2025. doi: 10.4330/wjc.v17.i5.106123
Circulating microRNAs in predicting fibrosis in hypertrophic cardiomyopathy: A systematic review
Maneeth Mylavarapu, Lakshmi Sai Meghana Kodali, Roopeessh Vempati, Jai Sivanandan Nagarajan, Ankit Vyas, Rupak Desai
Maneeth Mylavarapu, Public Health, Adelphi University, Garden City, NY 11530, United States
Lakshmi Sai Meghana Kodali, Public Health & Health Sciences, University of Michigan, Flint, MI 48502, United States
Roopeessh Vempati, Internal Medicine, Trinity Health Oakland Hospital, Pontiac, MI 48341, United States
Jai Sivanandan Nagarajan, Internal Medicine, SUNY Upstate Medical University, Syracuse, NY 13210, United States
Ankit Vyas, Cardiology, Ochsner Clinic Foundation, New Orleans, LA 70121, United States
Rupak Desai, Outcomes Research, Independent Researcher, Atlanta, GA 30079, United States
Co-first authors: Maneeth Mylavarapu and Lakshmi Sai Meghana Kodali.
Author contributions: Desai R, Mylavarapu M, and Kodali LSM performed data curation, visualization, and interpretation; Desai R has made significant contributions in terms of conceptualization, methodology, editorial work; Mylavarapu M, Kodali LSM, Vempati R, Nagarajan JS, Vyas A, and Desai R wrote the manuscript; Desai R, Mylavarapu M, and Vyas A reviewed and edited the manuscript; and all authors have read and approved the final manuscript. Mylavarapu M and Kodali LSM contributed equally to this article, they are the co-first authors of this manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA checklist of items, and the manuscript was prepared and revised according to the PRISMA checklist of items.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rupak Desai, MBBS, Outcomes Research, Independent Researcher, Scottdale, Atlanta, GA 30079, United States. drrupakdesai@gmail.com
Received: February 17, 2025 Revised: April 6, 2025 Accepted: April 28, 2025 Published online: May 26, 2025 Processing time: 96 Days and 2.4 Hours
Abstract
BACKGROUND
Hypertrophic cardiomyopathy (HCM) is characterized by left ventricular hypertrophy and interstitial fibrosis, which contribute to adverse outcomes such as heart failure and sudden cardiac death. While cardiac magnetic resonance (CMR) imaging is commonly used to detect myocardial fibrosis, circulating microRNAs (miRNAs) have emerged as promising noninvasive biomarkers for this condition due to their stability in blood plasma and resistance to pH and temperature variance.
AIM
To explore the role of specific circulating miRNAs in identifying myocardial fibrosis in patients with HCM.
METHODS
Using PubMed/MEDLINE and Google Scholar, we reviewed studies from 2014 to 2024 examining the link between circulating miRNAs and myocardial fibrosis in HCM. We included studies measuring miRNA expression in blood samples from HCM patients and assessing fibrosis via imaging, mostly CMR. Data extraction concentrated on the population, methodology, and findings related to the correlation between miRNA levels and fibrosis.
RESULTS
Seven studies involving 365 HCM patients with a mean age of 49.37 ± 10.5 years, 116 (31.78%) females, and one animal study identified miR-21, miR-29a, miR-133, miR-4454, and miR-221 as frequently dysregulated markers associated with fibrosis. Elevated levels of miR-21 and miR-29a correlated with more extensive fibrosis, as assessed by late gadolinium enhancement in CMR imaging, with miR-29a consistently linked to both fibrosis and hypertrophy across the studies.
CONCLUSION
Circulating miRNAs, particularly miR-21, miR-29a, and miR-221, show significant potential as biomarkers for myocardial fibrosis in HCM. Further research should validate these findings and investigate the clinical application of miRNA-based diagnostics in HCM.
Core Tip: Circulating microRNAs (miRNA) show promise as non-invasive biomarkers for myocardial fibrosis in hypertrophic cardiomyopathy (HCM). Our systematic review of eight studies identified miRNAs miR-21, miR-29a, and miR-221 as frequently dysregulated, with elevated miR-21 and miR-29a correlating with increased fibrosis detected by cardiac magnetic resonance imaging. These findings suggest that miRNAs could be a less invasive approach to the detection of fibrosis in HCM. However, the clinical validation of these findings has to be further validated with further research.
