Table 3

Examples of clinical studies evaluating cfDNA and miRNAs in advanced HF

ProbeSample sizeSample sourcePlatformResultsRefs.
Unmethylated FAM101A 74 STEMI patients versus 83 healthy subjectsPlasmaBisulfite sequencingHigher levels of cfDNA were strongly associated with STEMI patients 36
cfDNA19 ischaemic HF patients before and 12 hours after levosimendan infusionPlasmaqPCRcfDNA was significantly reduced in HF patients post-levosimendan treatment 37
mtDNA90 acute HF versus 109 chronic HF patientsPlasmaqPCRHigher levels of mtDNA were associated with mortality rate in patients with severe acute HF 39
miRNAs30 stable chronic HF patients versus 30 healthy controlsSerumqPCRHigher levels of miR-423–5 p, miR-320a, miR-22 and miR-92b may be useful diagnostic biomarker of chronic HF 43
miRNAs236 acute HF and 58 non-acute HF versus 44 stable chronic HFPlasmaqPCRBaseline low levels of miR-423-5 p were associated with a poor prognosis in acute HF 44
miRNAs96 acute HF patients followed up for 1 yearSerumqPCRLower miR-30d levels were strongly predictive of mortality in acute HF patients 45
miRNAs13 patients with congestive HF versus six healthy controlsCirculating mononuclear cellsqPCRmiR-210 levels were upregulated in severe NYHA III and IV versus NYHA II HF patients 46
miRNAs53 non-ischaemic HFrEF versus 39 healthy controlsSerum and peripheral blood circulating cellsGeniom Biochip miRNA Homo sapiens array, Agilent miRNA microarrayDowregulation of miR-558 and upregulation of miR-122* and miR-520d-5p may discriminate HFrEF patients 47
miRNAs39 HFrEF and 19 HFpEF patients versus 28 healthy controlsPlasmamiRCURY LNA microRNA ArraysUpregulation of miR-125a-5p, miR-550a-5p, miR-638 and downregulation of miR-190a may discriminate HFrEF from HFpEF 48
miRNAs90 HFrEF and 90 HFpEF versus 90 no-HF patients (control group)PlasmaTaqman miRNA arraysDifferential expression of miR-328, miR-30c, miR-221 and miR-375 could discriminate HFpEF and HFrEF 49
miRNAs23 NICM-HF and 41 ICM-HF versus 11 healthy controlsPlasmaqPCRUpregulation ofmiR-423/miR-34a and miR-21–3 p/miR-30a pairs may discriminate ICM-HF versus NICM-HF, respectively 8
miRNAs81 HF patients undergoing CRT versus 15 healthy controlsSerumqPCRUpregulation ofmiR-26b-5p, miR-145–5 p, miR-92a-3p, miR-30e-5p and miR-29a-3p was correlated to reverse remodelling in CRT responders 53
miRNAs52 HFrEF patients undergoing CRT versus 29 controls (with no cardiac diseases)PlasmaHuman MicroRNA microarray A and B cards, qPCRUpregulation of miR-30d was correlated to changes in left ventricle function after CRT 54
  • cfDNA, cell-free DNA; CRT, cardiac resynchronisation therapy; FAM101A, Refilin A; HF, heart failure; HFpEF, heart failure preserved ejection fraction; HFrEF, heart failure reduced ejection fraction; ICM-HF, ischaemic HF; miRNAs, microRNAs; mtDNA, mitochondrial DNA; NICM-HF, non-ischaemic HF; NYHA, New York Heart Association; qPCR, quantitative PCR; STEMI, ST-elevation myocardial infarction.