Microrna-21 is associated with the severity of right ventricular dysfunction in patients with hypoxia-induced pulmonary hypertension

Wei Ting Chang, Chih Hsin Hsu, Tzu Ling Huang, Ying Ching Tsai, Chun Yen Chiang, Zhih Cherng Chen, Jhih Yuan Shih

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10 Citations (Scopus)


Background: The outcome of pulmonary hypertension (PH) mainly depends on the development of right ventricular (RV) dysfunction, and survival among patients with different etiologies of PH varies. Chronic hypoxia is a major cause of secondary PH, however the mechanisms of its associated RV dysfunction are largely unknown. Herein, we studied the role of microRNA-21 (miR-21) in hypoxia-induced RV dysfunction. Methods: In this longitudinal, prospective study, we enrolled 41 patients with hypoxia-induced PH. Echocardiography was conducted and circulating miR-21 was measured. The expression of miR-21 was also evaluated in hypoxia-treated human pulmonary microvascular endothelial cells (HPECs) and conditioned media. Through the over-expression of miR-21 in H9C2 cells, we further identified crosstalk between the pulmonary circulation and RV. Results: Among the studied patients, 10 developed RV dysfunction. Notably, the expression of circulating miR-21 was correlated with the severity of RV dysfunction. Likewise, miR-21 was up-regulated in the hypoxia-treated HPECs and its conditioned media in a time-dependent manner. I addition, hypertrophic changes were observed in the hypoxia-treated HPECs. The up-regulation of heart failure-associated markers in H9C2 cells over-expressing miR-21 implied the influence of pulmonary circulatory miR-21 on RV function. Conclusions: The expression of systemic and pulmonary miR-21 is associated with the severity of RV dysfunction in patients with hypoxia-induced PH.

Original languageEnglish
Pages (from-to)511-517
Number of pages7
JournalActa Cardiologica Sinica
Issue number6
Publication statusPublished - 2018 Nov

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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