MicroRNA-126 Level Increases During Exercise Rehabilitation of Heart Failure with a Preserved Ejection Fraction

Figures & data

Table 1 Baseline Characteristics of 60 HFpEF Patients in This Study

	HFpEF Patients (n=60)
Age	68.3 ±7.8
Sex (male/female, n)	27 /33
BMI (Kg/m^2)	23±6
SBP (mmHg)	143±15
DBP (mmHg)	81±14
NYHA (II/III, n)	29/31
Coronary heart disease history (n)	39
Diabetes history (n)	45
Hypertension history (n)	38
Smoker (n)	11
Dyslipidemia (n)	31
Medication
Nitrates (n)	24
Statatin (n)	35
Aspirin (n)	27
Clopidogrel (n)	33
ACEI or ARB (n)	46
b-blockers (n)	35
Aldosterone inhibitors (n)	42
Thiazide diuretics (n)	23
Loop diuretics (n)	11
Insulin (n)	27

Abbreviations: BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; HFpEF, heart failure with preserved ejection fraction; NYHA, New York heart association; ACEI/ARB, angiotensin enzyme inhibitor/ angiotensin receptor blocker; b-blockers, b-adrenergic Receptor Antagonism.

Figure 1 Flowchart of HFpEF patient enrollment.

Table 2 Comparison of Data Obtained Before and After Rehabilitation

	Before Rehabilitation (n=60)	After Rehabilitation (n=50)	P
SDP (mmHg)	143 (15)	138 (17)	0.73
DBP (mmHg)	81 (14)	76 (12)	0.79
NT-proBNP (ng/mL)	1411 (293)	956 (143)	0.01
6MWT (m)	252 (82)	434 (65)	0.01
PeakVO2 (mL/min/kg)	13.5 (6.7)	16.6 (7.2)	0.02
VO2 AT (mL/min/kg)	9.1 (3.6)	12.1 (4.2)	0.03
METs	5.42 (1.61)	6.67 (1.89)	0.02
VE/VCO2slop	37.7 (5.1)	30.7 (5.5)	0.01
LVEF (%)	59.0 (8.3)	61.1 (7.6)	0.32
CI (L/min/m^2)	2.8 (0.5)	3.0 (0.6)	0.69
LAVI (mL/m^2)	36.7 (5.5)	31.5 (6.5)	0.04
LVMI (mg/m^2)	134.0 (33.3)	126.0 (27.3)	0.13
E/e’	16.4 (5.3)	13.1 (4.6)	0.04
MLHF	47 (13)	56 (14)	0.02
vWF (ng/L)	13.13 (3.47)	18.56 (5.14)	0.01

Abbreviations: SBP, systolic blood pressure; DBP, diastolic blood pressure; NT-proBNP, N-terminal prohormone brain natriuretic peptide; 6MWT, 6-minute walk test; LVEF, left ventricular ejection fraction; peakVO₂, peak oxygen uptake; VO₂AT, anaerobic threshold; METs, metabolic equivalents; VE/VCO₂slop, the slope of the relation between ventilation and carbon dioxide production; LVMI, left ventricular mass index; LAVI, left atrial volume index; CI, cardiac output index; E/e’, diastolic mitral flow velocity and diastolic mitral annulus velocity ratio; MLHF, the Minnesota Living With Heart Failure score; vWF, Von Willebrand Factor.

Table 3 Comparisons of miR-126 Levels in Plasma Between HFpEF Patients and Healthy Volunteers

	miR-126 Level
	At Baseline	After Rehabilitation
HFpEF patients (n=60)	3.09±0.56	4.35±0.79^#
Healthy volunteers (n=30)	9.56±1.87*^Δ

Notes: *P=0.01, compared to HFpEF patients at baseline; ^ΔP=0.01, compared to HFpEF patients after rehabilitation; ^#P=0.02, compared to baseline.

Table 4 Pearson Correlation Analysis Between miR-126 Expression Levels and Clinical Indicators in HFpEF Patients

Factors	R	P
NT-proBNP	−0.415*	0.01
6MWT	0.217	0.27
PeakVO2	0.531*	0.009
METs	0.498*	0.01
VO2 AT	0.461*	0.007
VE/VCO2slop	−0.271*	0.03
LVEF	0.476*	0.02
CI	0.187	0.41
LAVI	−0.459*	0.01
LVMI	−0.134	0.43
E/e’	−0.339*	0.01
MLHF	−0.497*	0.007

Note: *P<0.05.

Abbreviations: NT-proBNP, N-terminal prohormone brain natriuretic peptide; 6MWT, 6-minute walk test; peakVO₂, peak oxygen uptake; METs, metabolic equivalents; VO₂AT, anaerobic threshold; VE/VCO₂slop, the slope of the relation between ventilation and carbon dioxide production; CI, cardiac output index; LVEF, left ventricular ejection fraction LVMI, left ventricular mass index; LAVI, left atrial volume index; E/e’, diastolic mitral flow velocity and diastolic mitral annulus velocity ratio; MLHF, the Minnesota Living With Heart Failure score.

Table 5 Results of Multiple Linear Regression Analysis

Factors	B	Standard Error	P	Odds Ratio	95% Confidence Interval
NT-proBNP	−0.879	0.261	0.018	−2.513	−1.761~-3.206
PeakVO2	1.231	0.256	0.011	2.237	1.937–2.634
METs	1.513	0.315	0.021	2.076	1.678–2.913
MLHF	1.013	0.165	0.023	1.537	1.236–1.918

Abbreviations: NT-proBNP, N-terminal prohormone brain natriuretic peptide; peak VO₂, peak oxygen uptake; METs, metabolic equivalents; MLHF, Minnesota Living with Heart Failure questionary.

Figure 2 Correlation between miR-126 plasma expression levels and clinical indicators in HFpEF patients.

Abbreviations: NT-proBNP, N-terminal prohormone brain natriuretic peptide; peakVO2, peak oxygen uptake; METs, metabolic equivalents; MLHF, the Minnesota Living With Heart Failure score.