Int J Cardiol Heart Vasc. 2026 Jul 15;65:101975. doi: 10.1016/j.ijcha.2026.101975. eCollection 2026 Aug.
ABSTRACT
BACKGROUND: Current diagnostic tools for viral myocarditis (VM) present significant limitations. Recent studies have shown that microRNAs (miRNAs) are promising circulating biomarkers. The aim of this meta-analysis is to evaluate the diagnostic and prognostic role of miRNAs in VM.
METHODS: A systematic literature search was conducted across five databases (PubMed, Scopus, Embase, Google Scholar, and the Cochrane Library). Eligible studies reported miRNA diagnostic and/or prognostic accuracy in human subjects with VM diagnosis. Methodological quality of the included studies was assessed using the QUADAS-2 tool. Pooled estimates of area under the curve (AUC), sensitivity, specificity, and summary receiver operating characteristic (SROC) curves were calculated.
RESULTS: A total of 26 studies were included in our analysis; 42 differentially expressed miRNAs were identified; 30 exhibited upregulated expression, 9 demonstrated downregulation, and 3 had variable expression patterns. The pooled diagnostic AUC for VM was 0.897 (0.863-0.931; I2 = 93.4%); bivariate analysis yielded a pooled sensitivity of 0.758 (0.582-0.876; I2 = 87.1%) and specificity of 0.881 (0.811-0.928; I2 = 78.5%). Regarding fulminant myocarditis (FM) detection, the pooled AUC was 0.883 (95% CI: 0.837-0.930; I2 = 87.3%).
CONCLUSIONS: Circulating miRNAs represent promising candidate biomarkers for the diagnosis of VM, although the available evidence remains preliminary. Further large-scale prospective studies are needed to reproduce and validate these results.
PMID:42519745 | PMC:PMC13382395 | DOI:10.1016/j.ijcha.2026.101975