الفهرس | Only 14 pages are availabe for public view |
Abstract Heart failure is a chronic disease, which poses a growing problem for health systems worldwide as morbidity and mortality are increasing annually. HF can appear in the presence of reduced ejection fraction (HFrEF), mild reduced ejection fraction (HFmrEF) and preserved ejection fraction (HFpEF). The N-terminal pro-hormone brain natriuretic peptide (pro BNP) is secreted into the blood stream by cardiac myocytes in response to increased ventricular wall stress, it was regarded as a biomarker with potential role in distinguishing HF. Over the last decade, it has been found that circulating microRNAs are involved in the pathogenesis of cardiovascular diseases. MicroRNAs are endogenous, non-coding, single-stranded RNAs consisting of fewer than 22 nucleotides. It was reported that microRNA-19b, microRNA-21and microRNA 208a are involved in cardiovascular biology and disease and have received significant attention in the heart disease diagnosis. Identification of specific, reliable and sensitive biomarkers for HF is a field of active cardiovascular research, so the present study aimed to explore the association between the levels of circulating microRNAs 19b, 21, 208a and pro BNP with HF. The study included 45 cases of confirmed HF in addition 15 controls and categorized into 4 groups: 1. group I: Heart failure patients with preserved ejection fraction (HFpEF) assessed by echocardiography ≥ 50%. 2. group II: Heart failure patients with mild reduced ejection fraction (HFmrEF) assessed by echocardiography 40-50%. 3. group III: Heart failure patients with reduced ejection fraction (HFrEF) assessed by echocardiography ≤ 40%. 4. group IV: Apparently healthy persons with age and gender matched. All participants were subjected to detailed history, full clinical examination, liver function tests, kidney function, lipid profile, complete blood count, HbA1c, pro BNP and assessment of expression of microRNA19b, microRNA-21and microRNA 208aby real time PCR technique. The obtained results were as follow: ● There were no statistical significant differences between the studied groups as regard age and gender (P<0.05). However, there were statistically significant difference between the studied groups as regard HTN and diabetes (P value <0.01, 0.004 respectively). ● Ejection fraction was significantly reduced in (HFrEF) patients and in (HFmrEF) patients than (HFpEF) patients (P< 0.001). ● Total cholesterol, LDL-C and triglycerides were significantly higher in HF groups than controls (P<0.05). However, HDL-C level was significantly reduced in HF groups than controls (P <0.001). ● Hemoglobin level was significantly lower in HF groups (P<0.001). However, there were no significant differences regarding white blood cell count and platelet count (P> 0.05). ● ALT, AST, urea, creatinine and HbA1c were significantly higher in HF groups than controls (P<0.001). ● There was statistically significant difference between the studied groups regarding pro BNP (P<0.001), as HFrEF group was significantly higher than HFmrEF patients, as well HFmrEF group was significantly higher than HFpEF group. |