EN
MicroRNAs (miRNAs) are small non-coding,
single-stranded RNAs (19–25 nucleotides long) that regulate
expression of multiple target genes, predominantly by
binding to the 3′ untranslated region of messenger RNA
(mRNA) transcripts, resulting either in translational
inhibition or mRNA degradation. miRNAs are found in
many bodily fluids, including plasma and serum, and
are protected from degradation in the circulation through
association with lipids, proteins, or microparticles, making
them attractive disease biomarker candidates. Circulating
levels of cardiac miRNAs (including miR-1, miR-133a,
miR-208a, miR-208b, and miR-499) have been frequently
reported as elevated in both coronary heart disease
(CHD) and heart failure (HF) and have been proposed as
candidate biomarkers that reflect the severity of myocardial
injury. Subsequent large, array-based screening studies
comparing patients and controls have identified altered
expression of additional miRNAs, not just those of cardiac
origin. However, among these studies there has been
little consensus as to which miRNAs are top candidates
for diagnosis or prognosis in either CHD or HF. The
measurement of circulating miRNAs is further complicated
by the timing of collection, especially after acute cardiac
events while miRNA levels in blood may be rapidly
changing; confounding influences from medications or
contaminating blood cells at the time of sampling; and the
need for standardization of normalization strategies. This
review evaluates recent developments in the identification
of circulating miRNAs as markers for diagnosis and
prognosis in CHD and HF, and the methodological issues in
measurement of circulating miRNAs.