Extracellular RNAs as communicators in cardiovascular disease: a narrative review

Background and Objective: Cardiovascular disease (CVD) is a leading cause of death in industrialized countries. It consists of different etiologies and has linked to other types of diseases (e.g., diabetes, renal failure). Thus, understanding the disease mechanisms of CVD is of a great interest in the cardiovascular field. Because mammalian cardiomyocytes do not regenerate at a significant rate, if any, upon damage, cell therapy is an attractive therapeutic method to fight against CVD. To understand the disease mechanism as well as therapeutic approaches of CVD, recent advances in the field of extracellular RNAs (exRNAs) are increasing being appreciated for their involvement as cell-cell communication materials. Here, we summarize the current status of cardiac exRNAs to raise the awareness of this important field of study. Methods: For this mini-review, relevant articles related to exRNA by focusing on the CVD were searched in the PubMed database for publications written in English and published up to April 26, 2022. Key Content and Findings: These searches identified a number of non-coding RNAs [e.g., microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs)] as cardiac extracellular vehicles (EVs) affecting the cellular physiologies of cardiac cells as well as differentially expressed in CVD patients or animals compared to healthy donors, non-failing hearts, or control animals. Conclusions: By specifically focusing on publications with mechanistic findings, we highlight the importance of further research using genetic models and understanding the amount of exRNAs being transferred from one cell type to another to affect the phenotypes observed.