Profiling of MicroRNA Expression in Myocardial Samples

Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood through to meet the body 's needs for blood and oxygen. Basically, the heart can 't keep up with its workload. American Heart Association Statistics (2016) reveals that heart failure accounts for 36% of cardiovascular disease deaths. Projections report a 46% increase in the prevalence of Heart Failure (HF) by 2030 by affecting over 8 million people above 18 years with the disease. Healthy People 2020 goals are focused on attaining high quality longer lives free of preventable diseases, promotion of quality of life, healthy development and healthy behaviors across all stages of life (Healthy People 2020, 2015).

Heart Failure is a progressive heart disease when the muscle of the heart is weakened so that it cannot pump blood as it should; the blood backs up into the blood vessels around the lungs and the other parts of the body (NHS Choice, 2015). In heart failure, the heart is not able to maintain a normal range cardiac output to meet the metabolic needs of the body (Kemp and Conte, 2012). Heart failure is a major worldwide public health problem, it is the end stage of heart disease and it could lead to high mortality. At present, heart failure is usually associated with old age, given the dramatic increase in the population of older people (ACCF/AHA, 2013). In the USA, there are about 5.7 million adults who have heart failure, about half of the people die within 5 years of diagnosis, and it costs the nation an estimated $30.7 billion each year (ACCF/AHA, 2013).

Heart failure affects nearly 6 million Americans. It is the leading cause of hospitalization in people older than 65. Roughly 550,000 people are diagnosed with heart failure each year (Emory Healthcare, 2014). Heart failure is a pathologic state where the heart cannot pump enough blood to meet the demand of the body’s metabolic needs or when the ventricle’s ability to fill is impaired. It is not a disease, but rather a complex clinical syndrome. The symptoms of heart failure come from pulmonary vascular congestion and inadequate perfusion of the systemic circulation. Individuals experience orthopnea,

Heart failure (HF) is defined as a multifaceted clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. In HF, the heart may not provide tissues with adequate blood for metabolic needs, and cardiac-related elevation of pulmonary or systemic venous pressures may result in organ congestion1. In the United States, HF is increasing in incidence with about 5.1 million people suffering from HF and half of people who develop HF die within 5years 2. Over 75% of existing and new cases occurred in individuals over 65 years of age, < 1% in individuals below 60 years, nearly 10% in those over 80 years of age. HF costs the

Heart failure (HF) is one of the leading causes of hospital admissions and readmissions in the United States (Desai & Stevenson, 2012; Gheorghiade, Vaduganathan, Fonarow, & Bonow, 2013). It is a condition that accounts for a very high morbidity and mortality (Bakal, McAlister, Liu, & Ezekowitz, 2014). Every hospital admission for heart failure patients results in disease progression and poor prognosis. For chronic HF patients, a hospitalization is one of the strongest prognostic predictors for increased mortality (Gheorghiade et al., 2013). Factoring in re-hospitalizations, especially at 30-day to 90-day mark, it is increasingly detrimental to patient prognosis.

Congestive heart failure (CHF) is a syndrome that occurs when the heart cannot pump sufficient blood to meet the tissues metabolic and oxygen needs. As a result, intravascular/ interstitial volume overload and poor tissue perfusion occurs. An individual with heart failure experiences reduced exercise tolerance, a reduced quality of life and shortened life span. The most common cause of heart failure is coronary artery disease (CAD). The incidence of heart failure increases with age. Approximately 1% of people over the age of 50 and 10% of people over the age of 80 experience heart failure. The prognosis depends on underlying cause and response to treatment. Heart failure may be classified according to the side of the heart affected.

Heart failure is a major health problem worldwide, but especially in the United States. The CDC estimates that over 5.7 million Americans are living with heart failure, and that

Heart failure is more commonly diagnosed in the elderly population. There are ways to help manage heart failure like lifestyle modifications and use of pharmacology, and assessment for surgical intervention. Treatment of heart failure requires intensive medical, dietary, behavioral, and lifestyle modification to achieve improved quality of life, fewer hospitalizations, and decreased mortality (Singh, H., McGregor, Nigro, Higginson, and Larsen, 2014).

Heart failure is a chronic, debilitating disease affecting 5.1 million Americans. It is the most common cause of hospital admissions for Medicare beneficiaries, and is the diagnosis associated with most readmissions (Sterne, Grossman, Migliardi, & Swallow, 2014). Lower quality of life is experienced by patients with heart failure. Mortality rates remain high with about 30% of patients dying within the first year after diagnosis (Vellone et al., 2013). In the U.S. heart failure has become a major public health concern. The number of annual hospitalizations for individuals with heart failure increased from 2.4 million to 3.6 million from 1990 to 1999 (Veroff et al., 2012). Therefore, it is imperative to develop interventions to better

Morita (2005) stated that ‘recent insights into molecular genetic causes of myocardial diseases have highlighted the importance of single-gene defects in the pathogenesis of heart failure’. The information we can collect from investigation of gene defects, and an understanding of how genetics contributes to the development of heart failure, will ultimately help in prevention, treatment and possibly cure of cardiomyopathies in the future but we must also consider the environmental factors role.

Heart failure is a syndrome that involves dysfunction of the cardiac muscle that results in or increase the risk of developing manifestations of low cardiac output and/or pulmonary or systemic congestion (Grossman & Porth, 2014). The National Heart, Lung, and Blood Institute estimate that about 5.8 million people in the United States have heart failure. Even though heart failure can occur in any age group, it primarily affects older adults. Although morbidity and mortality rates from other cardiovascular diseases have decreased over the past several decades, the incidence of heart failure is increasing at an alarming rate. Approximately 400,000 to 700,000 people are diagnosed with heart failure each year (Grossman &

Heart failure (HF) is defined as a chronic progressive disease in which the cardiac muscle is not able to pump an adequate amount of blood to fulfill the body's requirement for blood and oxygen. (American heart association, 2016 sep 28) In the United State of the America, Near to 5.7 million people are diagnosed with heart failure (Mozzafarian D, Benjamin EJ, Go AS, et al), with overall estimated heart failure costs exceeding $30 billion each year (Heidenreich PA, Trogdon JG, Khavjou OA, Butler J, Dracup K, Ezekowitz MD, et al.). In the United States, Heart failure is one of the leading causes of hospitalization in elderly people. Because of improvement in health care services such as diagnosis and treatment options, the number of people living

Heart failure is a chronic and progressive disease process that involves weakening of the heart. A weak heart cannot adequately pump oxygenated blood to the body’s tissues. The reduction of the oxygenated blood to the body triggers mechanisms in the body to compensate for decreased blood flow. First, the baroreceptors within the heart detect decreased blood flow which signals the sympathetic nervous system. This triggers a release of epinephrine and norepinephrine causes an increase in heart rate as well as vasconstriction. The renal system responds by releasing renin which activates the renin-angiotensin-aldosterone system which causes sodium and water retention to increase blood volume. Unfortunately, this is a vicious cycle that intends to help the heart but ultimately weakens it causing hypertrophy of heart muscle and various symptoms. Since this disease cannot be cured, the treatment involves delaying the progression of disease and treating the symptoms. Heart failure is the most common reason for hospitalization in those over 65 due to exacerbations and progression of the condition. (Hinkle & Cheever, 2014)

Investigations performed at the gene level delineate differences in the mRNA and miRNA protein gene expressions between the two ventricles, with higher levels of expression concentrated in LV 11. Other reports suggest differences at the protein levels of the two ventricles wherein higher amounts of energy using proteins like ATP synthase and others like Heat Shock Protein (HSP), Myosin Binding Protein C (MBPC) and Myosin Light Chain 2 (MLC2) were noted in Left compared to the Right ventricles in healthy mice hearts 5, 24, 38.

As the population ages heart failure is expected to increase exceptionally. About twenty-two percent of men and forty-four percent of women will develop heart failure within six years of having a heart attack. “Thirty years ago patients would have died from their heart attacks!” (Couzens)