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

Figures

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  Figure 1. Workflow of the literature review about potential diagnostic serum microRNAs for myocardial infarction. The literature search was conducted via PubMed in the MEDLINE database. From 109 publications, 19 articles were identified presenting potential diagnostic serum microRNAs for myocardial infarction in human. Abbreviation: n, number of publications.

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  Figure 2. Distribution of ratios of reliably detectable microRNAs in marathon runners. The distribution of ratios of reliably detectable microRNAs in marathon runners ranges from 0.22 to 2.13. According to the ratios of these 155 microRNAs, 12 microRNAs demonstrate upregulation (cut-off value 1.5), while 67 microRNAs present downregulation (cut-off value 1/1.5) in the high cTnT cohort compared to the low cTnT cohort. In contrast, 76 microRNAs show no relevant differences of marathon-induced dysregulations between both cohorts. Ratios were calculated based on microRNA expressions from next-generation sequencing (see material and methods). Abbreviation: cTnT, cardiac troponin T.

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  Figure 3. Pearson’s correlation coefficient of microRNAs and cardiac troponin T after the marathon. Pearson’s correlation coefficient was performed on relative quantities of microRNA expressions after the marathon and cTnT concentrations after the marathon of runners. Eight microRNAs present significant positive correlations. The highest correlation coefficient belongs to miR-133a-3p with r = 0.39. Natural log transformation was performed on data. Linear regression line and 95% confidence interval (blue area around the regression line) are plotted for significant correlations. Adjustment of p-values for multiple testing was performed based on false discovery rate according to Benjamini and Hochberg. MicroRNA expressions were attained by means of quantitative real-time polymerase chain reaction. Abbreviations: cTnT, cardiac troponin T; r, correlation coefficient; RQ, relative quantity.

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  Figure 4. Fold change differences of microRNAs between the low and high cTnT cohort. Comparing central tendencies of microRNA fold changes between the low and high cTnT cohort, three microRNAs are upregulated in patients with elevated cTnT concentrations, none is downregulated, and three are not significantly different. The two-sided Mann–Whitney U test (exact p-value) was applied. Adjustment of p-values for multiple testing was performed based on false discovery rate according to Benjamini and Hochberg. MicroRNA expressions for calculation of fold changes (see material and methods) were attained by means of quantitative real-time polymerase chain reaction. Abbreviation: cTnT, cardiac troponin T.