Circulating microRNA dysregulation in hypertrophic cardiomyopathy, arrhythmogenic cardiomyopathy, and dilated cardiomyopathy: a systematic review

: Hypertrophic cardiomyopathy (HCM), arrhythmogenic cardiomyopathy (ACM) and dilated cardiomyopathy (DCM) represent the most frequent structural heart disorders. Due to the complexity of their diagnosis and the frequent occurrence of sudden cardiac death as the first manifestation, these diseases impose a relevant socio-economic burden, highlighting the urgent need for novel disease-specific biomarkers. Here, we assess the potential of microRNAs (miRNAs) as non-invasive predictors for HCM, ACM, and DCM. Electronic databases were systematically searched using relevant keywords pertaining to the disorders and miRNAs. To minimize spurious associations, only studies reporting the area under the curve (AUC) and including healthy controls were taken into account, resulting in the selection of 19 papers for further analyses. miR-29a-3p, miR-185-5p, and miR-454-3p were found overexpressed in HCM, ACM, and DCM, respectively, across different studies. Assessment of the correlation between circulating miRNA levels and cardiac features or genetic background failed to detect consistent profiles among different studies. Thus, further investigations employing consistent approaches and larger cohorts are required to validate the clinical utility of circulating miRNAs as non-invasive biomarkers for these structural cardiomyopathies.Systematic review registration PROSPERO CRD42023330236.