Distinguish between a myocarditis and a myocardial infarction from a biomarker (substance) in the blood. It is an important finding of Spanish researchers from the National Center for Cardiovascular Research (CNIC), which could become a useful tool in clinical practice for making accurate, noninvasive diagnoses of myocarditis with just a drop of blood.
The study, led by researcher Pilar Martín and published in The New England Journal of Medicine, identified a novel microRNA (human homologous miR-721) in the blood of patients with acute myocarditis.
That is, they have been able to recognize a blood substance for myocarditis, a heart condition with symptoms very similar to those of a myocardial infarction and that, in most cases, can only be diagnosed by making an urgent catheterization of the patient.
High sensitivity
This biomarker, with a high sensitivity and a specificity of more than 90%, can help diagnose myocarditis and differentiate it from other cardiomyopathies and other inflammatory diseases of autoimmune origin, as explained by the general director of the Spanish CNIC, Valentín Fuster, in a statement from the BBVA Foundation, which has contributed to the funding of the research.
The finding of miR-721 took place in the plasma of mice with autoimmune and viral myocarditis. This miRNA is synthesized by the autoimmune Th17 cells that recognize cardiac antigens derived from proteins such as alpha-myosin and attack the myocardium, being largely responsible for the pathophysiology of the disease, say Rafael Blanco-Domínguez and Dr. Raquel Sánchez-Díaz, the first authors of the study.
How to stop myocarditis?
Myocarditis is an inflammatory heart disease caused by pathogens, toxins, drugs, or autoimmune disorders, which, if not treated, can cause dilated cardiomyopathy, require a heart transplant, or cause death. Although the most common cause of myocarditis is a viral infection, it may also be secondary to some treatments for other pathologies.
Myocarditis is a side effect that, although very rare, is potentially serious in patients with immunotherapies, Sánchez-Díaz points out, but there are no specific markers to diagnose it in these cases.
Diagnosis of myocarditis continues to be a challenge, and having a sensitive and specific marker of myocardial acute inflammation could have a major clinical impact on improving the diagnosis of acute myocarditis in general, and early diagnosis in particular, the researchers note.
Future studies will assess the potential of the biomarker to predict short- and long-term risk, among other aspects.
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