BACKGROUND MicroRNA-21(miR-21)is related to hypertension and cardiac remodelling.Left atrium(LA)dilation is highly sensitive to small haemodynamic changes in the left ventricle(LV)that are induced by hypertension.This study aimed to elucidate the relationship between miR-21 expression and LA dilation in elderly patients with essential hypertension(EH).METHODS In this cross-sectional study,one hundred elderly patients with EH were recruited for the study.According to their left atrium diameters(LADs),the patients were divided into the LA dilation group[42 patients(42%)]and the no-LA dilation group[58 patients(58%)].The serum levels of miR-21 and chemical biomarkers used in the clinic,such as creatinine,blood urea nitrogen,uric acid,fasting blood glucose,total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDLC),low-density lipoprotein cholesterol(LDL-C),very-low-density lipoprotein cholesterol,Lp(a),apolipoprotein A1(apoA1),and apolipoprotein B,were measured.All the patients underwent echocardiographic examination,and the LAD,interventricular septum(IVS),right atrium diameter(RAD),right ventricle diameter(RVD),left ventricular end-systolic diameter(LVESD),left ventricular end-systolic diameter(LVEDD)and left ventricular ejection fraction(LVEF)were measured.RESULTS The levels of miR-21[8.02(5.21,14.39)vs.6.05(3.81,8.95),P=0.011]and LVEF(67.02±3.82 vs.64.14±4.43,P=0.001)were higher in the LA dilation group.The levels of creatinine[70.40(64.45,80.15)vs.63.9(60.1,73.43)],P=0.020]were higher in the no-LA dilation group.The levels of HDLC(r=-0.209,P=0.037),apoA1(r=-0.269,P=0.007)and RAD(r=0.203,P=0.043)were significantly correlated with miR-21 expression.The LAD was significantly correlated with the RAD(r=0.287,P=0.004),RVD(r=0.450,P<0.001),LVEDD(r=0.248,P=0.013)and LVEF(r=0.232,P=0.020).Multivariate logistic regression revealed that miR-21 significantly influenced LA dilation in elderly patients with EH(P<0.05).CONCLUSIONS Circulating serum levels of miR-21 are increased in elderly patients with EH with LA dilation.miR-21 levels are significantly correlated with LA dilation in elderly patients with EH,and miR-21 may be a factor related to the clinical pathophysiological occurrence of and treatment for the progression of hypertension-related early heart damage in EH patients.
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