Plasma Extracellular Vesicles as Liquid Biopsy to Unravel the Molecular Mechanisms of Cardiac Reverse Remodeling Following Resynchronization Therapy?

Frans A van Nieuwenhoven; Blanche Schroen; Lucio Barile; Lars van Middendorp; Frits W Prinzen; Angelo Auricchio

doi:10.3390/jcm12020665

Plasma Extracellular Vesicles as Liquid Biopsy to Unravel the Molecular Mechanisms of Cardiac Reverse Remodeling Following Resynchronization Therapy?

J Clin Med. 2023 Jan 13;12(2):665. doi: 10.3390/jcm12020665.

Authors

Frans A van Nieuwenhoven¹, Blanche Schroen², Lucio Barile³, Lars van Middendorp⁴, Frits W Prinzen¹, Angelo Auricchio⁵

Affiliations

¹ Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, 6200 MD Maastricht, The Netherlands.
² Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University, 6200 MD Maastricht, The Netherlands.
³ Laboratory for Cardiovascular Theranostics, Istituto Cardiocentro Ticino, 6900 Lugano, Switzerland.
⁴ Department of Cardiothoracic Surgery, Maastricht University Medical Center, 6200 MD Maastricht, The Netherlands.
⁵ Department of Cardiology, Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland.

Abstract

Cardiac resynchronization therapy (CRT) has become a valuable addition to the treatment options for heart failure, in particular for patients with disturbances in electrical conduction that lead to regionally different contraction patterns (dyssynchrony). Dyssynchronous hearts show extensive molecular and cellular remodeling, which has primarily been investigated in experimental animals. Evidence showing that at least several miRNAs play a role in this remodeling is increasing. A comparison of results from measurements in plasma and myocardial tissue suggests that plasma levels of miRNAs may reflect the expression of these miRNAs in the heart. Because many miRNAs released in the plasma are included in extracellular vesicles (EVs), which protect them from degradation, measurement of myocardium-derived miRNAs in peripheral blood EVs may open new avenues to investigate and monitor (reverse) remodeling in dyssynchronous and resynchronized hearts of patients.

Keywords: cardiac resynchronization therapy; dyssynchrony; extracellular vesicles; heart failure; microRNA.

Publication types

Review

Grants and funding

B.S. was financially supported by the CVON-SHE-PREDICTS-HF of The Netherlands Heart Foundation. L.v.M. and experiments presented were financially supported within the framework of CTMM, the Center for Translational Molecular Medicine (www.ctmm.nl), project COHFAR (grant 01C-203), and supported by the Dutch Heart Foundation.