The role of non-coding RNAs in myocarditis: a narrative review

BACKGROUND AND OBJECTIVE: Myocarditis is a heterogeneous disease that can lead to acute heart failure, dilated cardiomyopathy (DCM), and sudden death. However, the knowledge of the precise molecular mechanisms of myocarditis is fairly limited. In recent years, non-coding RNAs (ncRNAs) have been demonstrated to be involved in many physiological and pathological processes in myocarditis and to have the potential to be used as novel diagnostic and therapeutic strategies for myocarditis. This review summarizes the role of ncRNAs in myocarditis and discusses their potential as noninvasive biomarkers and therapeutic targets for myocarditis. METHODS: Literature on ncRNAs and myocarditis published in PubMed was extensively reviewed for analysis and discussion. KEY CONTENT AND FINDINGS: This review describes the roles of different ncRNAs in myocarditis and summarizes their potential in diagnosing and treating myocarditis. Multiple functions and mechanisms of ncRNAs in myocarditis have been uncovered. CONCLUSIONS: Current studies show that ncRNAs are widely involved in the occurrence and development of myocarditis caused by infection, autoimmunity, and the use of immune checkpoint inhibitors (ICIs) through their regulation of cell apoptosis, immune response, viral replication, and other aspects. Small-sample clinical studies have assessed the diagnostic value of ncRNAs. These results provide a new theoretical basis for diagnosing and treating myocarditis.