Diagnostic Value of miRNA Expression for Elderly Hypertension with Early Heart Function Injury

Background Our objective is to investigate associations between miRNA expression profiles and echocardiographic cardiac structural parameters and to evaluate the diagnostic utility of miRNA biomarkers for identifying left ventricular diastolic dysfunction (LVDD) in older adults with essential hypertension (EH). Methods Clinical data and serum samples were collected from 10 older adults with EH (5 LVDD, 5 non-LVDD controls). Then, miRNA high-throughput sequencing (HTS) was carried out on the serum samples to define differentially expressed miRNAs (DE-miRNAs) between both groups. In the subsequent validation experiment, we collected serum samples, basic clinical data, and echocardiographic data from 237 elderly EH patients (149 Non-LVDD and 88 LVDD) from four tertiary A-level hospitals in Hebei Province. Serum DE-miRNA levels were quantified via RT-PCR, and associations with echocardiographic parameters were analyzed via Spearman's rank correlation. The diagnostic efficacy of miRNAs for LVDD was assessed using the ROC curve. Results The HTS results identified 34 DE-miRNAs between both groups (P < 0.05). Four serum-abundant miRNAs (miR-19b-3p/21-5p/15a-5p/30e-5p) were selected for diagnostic performance validation, revealing that serum circulating miR (c-miR)-19b-3p/21-5p/30e-5p were significantly differential expressed between both groups (P < 0.05). Spearman analysis manifested significant associations between miR-19b-3p and LV function parameters (LVEF, FS, e', A, E/e') and right ventricular (RV) structural parameters (P < 0.05). miR-30e-5p showed significant correlations with LV function indices (LVEF, FS, E, A, E/e'; P < 0.05). miR-15a-5p was significantly related to LV function parameters (LVEF and FS; P < 0.05). Multivariate regression analysis showcased that serum c-miR-19b-3p/21-5p/15a-5p served as independent risk factors for LVDD in elderly hypertension (HTN) patients (P < 0.05). ROC curve analysis manifested that miR-19b-3p exhibited the maximum AUC value (0.735) among the four miRNAs for diagnosing LVDD in elderly HTN patients, with diagnostic sensitivity and specificity of 88.64% and 46.98%, respectively. Combinatorial analysis showed that the combined detection of miR-19b-3p/21-5p/30e-5p significantly improved the diagnostic AUC to 0.915 (P < 0.05), with enhanced sensitivity (86.36%) and specificity (89.93%). Conclusions This study revealed that c-miR-19b-3p serum levels in elderly HTN patients demonstrated moderate diagnostic value (AUC = 0.735) for identifying LVDD. The combined use of miR-19b-3p/21-5p/30e-5p as a diagnostic panel significantly enhanced the predictive efficacy for LVDD occurrence (AUC = 0.915). These findings establish a theoretical foundation for miRNA clinical application in early diagnosis and therapeutic management of cardiac functional impairment in elderly HTN patients.