The role of circulating microRNAs in the diagnosis of Takotsubo cardiomyopathy

Their research included TTC patients (n=36), ST segment elevation myocardial infarction patients (STEMI, n=27) and healthy controls (n=28). After the preliminary selection of miRNAs, eight kinds of miRNAs were considered for further verification by RT-PCR. Researchers eventually found that, compared with healthy controls, miRNA-16 and miRNA-26a were both up-regulated in patients with TTC (both P <0.001). Compared to STEMI patients, miRNA-16, miRNA-26a and let7f all increased in patients with TTC (respectively P <0.0001, P <0.05 and P <0.05). As in the previous studies, this study also found that cardiac-specific miRNA-1 and miRNA-133a increased notably in STEMI patients compared with healthy controls (both P <0.0001). In addition, miRNA-133a increased more in STEMI patients compared with TTC patients (P <0.05). A unique signature comprising miRNA-1, miRNA-16, miRNA26a and miRNA-133a distinguished TTC patients from healthy controls [area under the curve (AUC) 0.835, 95% CI 0.7330.937, P <0.0001] and STEMI patients (AUC 0.881, 95% CI 0.793-0.968, P <0.0001). In comparison of TTC patients with healthy controls, the sensitivity and specificity of these markers were 74.19% and 78.57%; in comparison TTC patients with STEMI patients, the sensitivity and specificity were 96.77% and 70.37%. The researchers also found that, compared with healthy controls, the plasma endothelin -1 (ET-1) in TTC patients was elevated. However, the ET-1 regulator, miR-125a-5p was reduced in parallel. In the clinic, diagnostic biomarkers remain an important tool in risk prediction, and determining treatment options during the acute phase of different disease processes. Milosz Jaguszewski and his colleagues have found that four kinds of circulating miRNAs can better distinguish between TTC and STEMI patients. They demonstrate for the first time a unique signature of circulating miRNAs for the sensitive and specific identification of TTC and for distinguishing TTC from STEMI patients. This signature may hold great promise to become an important diagnostic tool for the diagnosis of TTC, just like the discussed markers (BNP and TnI). The true roles of circulating miRNAs need to be confirmed in a larger patient population in prospective investigations. Statement of ethical publishing