Functional Significance of Cardiac Rehabilitation-Regulated Expression of Circulating MicroRNA-423-5p in Hypertensive Patients with Heart Failure with a Moderately Reduced Ejection Fraction.

BACKGROUND: Hypertension is a vital risk factor for heart failure, while cardiac rehabilita-tion can effectively improve cardiac function of heart failure patients. This study aimed to determine the impact of cardiac rehabilitation on microRNA-423-5p in hypertensive patients with heart failure with a moderately reduced ejection fraction.

METHODS: Sixty hypertensive patients with heart failure with a moderately reduced ejec-tion fraction were randomly divided into cardiac rehabilitation group and positive control group with 30 cases per group, while 30 hypertensive patients without heart failure were recruited as negative control group. The cardiac rehabilitation group and positive control group were treated with 1-month cardiac rehabilitation combined with the routine treat-ment and routine treatment only, respectively. The New York Heart Association classi-fication, 6-minute walking test, and color Doppler echocardiography were adopted to detect cardiac function. Meanwhile, the expression of microRNA-423-5p and N-terminal pro-B-type natriuretic peptide was determined via Real-Time Fluorescence Quantitative PCR and electrochemiluminescence immunoassay. The diagnostic potential of microR- 423-5p and N-terminal pro-B-type natriuretic peptide was assessed by ROC curve analy- sis and multivariate linear regression model.

RESULTS: Patients in cardiac rehabilitation group displayed significantly lower expression of microR-423-5p and better results of New York Heart Association classification, 6-min-ute walking test, and color Doppler echocardiography than those in positive controlgroup (P < .05). ROC analysis showed that microR-423-5p (AUC = 0.785; 95% CI: 0.686- 0.865; sensitivity = 73.33%; specificity = 73.33%) had better specificity and accuracy thanN-terminal pro-B-type natriuretic peptide (AUC=0.721; 95% CI: 0.617-0.811; sensitiv- ity = 81.67%; specificity = 63.33%).

CONCLUSION: MicroR-423-5p was implicated in left ventricular hypertrophy and might be a potential biomarker for assessing the therapeutic effect of cardiac rehabilitation on hypertensive patients with heart failure with a moderately reduced ejection fraction.