Circulating miR-29 and miR-320 as biomarkers of clinical compensation in ischaemic and non-ischaemic dilated cardiomyopathy
Abstract
Background
Patients with dilated cardiomyopathy (DCM) may present as clinically compensated or decompensated despite similar degrees of ventricular dysfunction, suggesting that clinical compensation reflects distinct pathophysiological states that may differ across disease aetiologies. This study aimed to evaluate whether circulating miR-29 and miR-320 are associated with clinical compensation status in ischaemic dilated cardiomyopathy (IDCM) and non-ischaemic dilated cardiomyopathy (NIDCM), and to determine whether these associations demonstrate aetiology-specific patterns.
Methods
This study included 46 patients with IDCM, 44 with NIDCM and 30 controls. Clinical compensation was defined by New York Heart Association (NYHA) class, supported by evaluation of congestion signs. Plasma miR-29 and miR-320 were quantified by reverse transcription quantitative polymerase chain reaction (RT-qPCR) using miR-103 for normalisation, with aetiology-stratified comparisons performed using non-parametric analyses.
Results
Baseline microRNA (miRNAs) expression differed by aetiology. miR-29 was higher in IDCM than in NIDCM and controls (p < 0.001), whereas miR-320 was elevated in both IDCM and NIDCM relative to the controls (p = 0.003 and 0.009, respectively). In IDCM, compensated patients exhibited higher miR-29 levels than decompensated patients (p = 0.024). NIDCM, decompensated patients showed higher miR-320 levels than compensated patients (p = 0.027). The alternate miRNA did not vary with the compensation status.
Conclusion
Circulating miR-29 and miR-320 demonstrate distinct, aetiology-dependent clinical significance in DCM. miR-29 was associated with clinical compensation specifically in IDCM, whereas miR-320 is associated with decompensation in NIDCM. These findings suggest potential aetiology-specific biological pathways underlying clinical stability and should be considered as hypothesis generating, warranting confirmation in larger and longitudinal studies.
© 2026 Mark Onsy Dimitry, Osama Louis, Solaf Ahmed Kamel, Eman Mahmoud Hassan, Rasha Nazih, Sally M. Hafez, Amira N. Ahmed, Amira Fawzy Soliman, Eman Awadallah, published by Romanian Society of Cardiology
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