P2790microRNA-21 as a prognostic biomarker of sacubitril/valsartan treatment response in heart failure with reduced ejection fraction

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Purpose: MicroRNAs (miRs) modulate cardiovascular development and disease by post-transcriptional gene expression regulation and thus they are emerging as potential biomarkers and promising therapeutic targets in cardiovascular disease. Although sacubitril/valsartan, a first in class angiotensin-receptor-neprylisin inhibitor (ARNI), has recently shown its benefits and safety in symptomatic patients with chronic heart failure with reduced ejection fraction (HFrEF), there is no evidence yet on predicted markers for its efficacy. The aim of this study is to evaluate miR-208b, miR-499, miR-21, miR-1, miR-133a and miR-26b gene expression levels as prognostic markers of sacubitril/valsartan treatment response in patients with HFrEF Methods: We included 25 symptomatic patients (aged 68±10 years) with chronic HFrEF (LVEF <35%) and New York Heart Association (NYHA) class II/III, who received sacubitril/valsartan (mean dose of 94±45 mg/day) on optimal medical treatment. All patients underwent a serial assessment with standard conventional transthoracic and a two-dimensional speckle tracking echocardiography at baseline and at 6 months follow-up. MiRs expression levels in peripheral blood mononuclear cells were quantified by real-time reverse transcription polymerase chain reaction.

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