Marathon-Induced Cardiac Strain as Model for the Evaluation of Diagnostic microRNAs for Acute Myocardial Infarction

• Published in: Journal of clinical medicine 2021-12, Vol.11 (1), p.5
• Main Authors: Shirvani Samani, Omid, Scherr, Johannes, Kayvanpour, Elham, Haas, Jan, Lehmann, David H, Gi, Weng-Tein, Frese, Karen S, Nietsch, Rouven, Fehlmann, Tobias, Sandke, Steffi, Weis, Tanja, Keller, Andreas, Katus, Hugo A, Halle, Martin, Frey, Norbert, Meder, Benjamin, Sedaghat-Hamedani, Farbod
• Format: Article
• Language: English
• Subjects: Biomarkers; Clinical medicine; Heart attacks; Marathons; MicroRNAs; Physiology; Running
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm11010005

The current gold standard biomarker for myocardial infarction (MI), cardiac troponin (cTn), is recognized for its high sensitivity and organ specificity; however, it lacks diagnostic specificity. Numerous studies have introduced circulating microRNAs as potential biomarkers for MI. This study investigates the MI-specificity of these serum microRNAs by investigating myocardial stress/injury due to strenuous exercise. MicroRNA biomarkers were retrieved by comprehensive review of 109 publications on diagnostic serum microRNAs for MI. MicroRNA levels were first measured by next-generation sequencing in pooled sera from runners ( = 46) before and after conducting a full competitive marathon. Hereafter, reverse transcription quantitative real-time PCR (qPCR) of 10 selected serum microRNAs in 210 marathon runners was performed (>10,000 qPCR measurements). 27 potential diagnostic microRNA for MI were retrieved by the literature review. Eight microRNAs (miR-1-3p, miR-21-5p, miR-26a-5p, miR-122-5p, miR-133a-3p, miR-142-5p, miR-191-5p, miR-486-3p) showed positive correlations with cTnT in marathon runners, whereas two miRNAs (miR-134-5p and miR-499a-5p) showed no correlations. Upregulation of miR-133a-3p ( = 0.03) and miR-142-5p ( = 0.01) went along with elevated cTnT after marathon. Some MI-associated microRNAs (e.g., miR-133a-3p and miR-142-5p) have similar kinetics under strenuous exercise and MI as compared to cTnT, which suggests that their diagnostic specificity could be limited. In contrast, several MI-associated microRNAs (miR-26a-5p, miR-134-5p, miR-191-5p) showed different release behavior; hence, combining cTnT with these microRNAs within a multi-marker strategy may add diagnostic accuracy in MI.