Emerging role of microRNAs in dilated cardiomyopathy: evidence regarding etiology

Abstract

Dilated cardiomyopathy (DCM) is a heart muscle disease characterized by ventric ular dilation and systolic dysfunction in the absence of abnormal loading conditions or coronary artery disease. This cardiac disorder is a major health problem due to its high prevalence, morbidity, and mortality. DCM is a complex disease with a common phenotype but heterogeneous pathological mechanisms. Early etiologi cal diagnosis and prognosis stratification is crucial for the clinical management of the patient. Advances in imaging technology and genetic tests have provided use ful tools for clinical practice. Nevertheless, the assessment of the disease remains challenging. Novel noninvasive indicators are still needed to assist in decision making. microRNAs (miRNAs), a group of small noncoding RNAs, have been identi fied as key mediators of cell biology. They are found in a stable form in body fluids and their concentration is altered in response to stress. Previous research has sug gested that the miRNA signature constitutes a novel source of noninvasive bio markers for a wide array of cardiovascular diseases. Specifically, several studies have reported the potential role of miRNAs as clinical indicators among the etiolo gies of DCM. However, this field has not been reviewed in detail. Here, we summa rize the evidence of intracellular and circulating miRNAs in DCM and their usefulness in the development of novel diagnostic, prognostic and therapeutic approaches, with a focus on DCM etiology. Although the findings are still prelimi nary, due to methodological and technical limitations and the lack of robust population-based studies, miRNAs constitute a promising tool to assist in the clinical management of DCM. (Translational Research 2019; 000:1 16)