Metabolic Reprogramming in Heart Failure: From Energy Starvation to Therapeutic Targets.

IF 0.6 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Treatment Options in Cardiovascular Medicine Pub Date : 2025-01-01 Epub Date: 2025-10-07 DOI:10.1007/s11936-025-01121-2

Mariam Meddeb, Joseph R Goldenberg, Sydney C Jenkin, Virginia S Hahn

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引用次数: 0

Abstract

Purpose of review: The goals of this review are to summarize the current literature regarding metabolic abnormalities in heart failure and propose therapies that can induce metabolic reprogramming to benefit the diseased heart.

Recent findings: Analysis of cardiac and skeletal muscle metabolism in heart failure has revealed several abnormalities including lower PCr/ATP ratio (indicating diminished myocardial energy reserves), altered substrate utilization, and mitochondrial abnormalities. Several advances in both non-invasive and invasive methods to studying cardiac metabolism have allowed recent key contributions to the field. Promising therapeutic strategies include shifting towards increased utilization of ketones and fatty acids, targeting mitochondrial biogenesis and function, and activation of genes that promote metabolic remodeling. Several current therapies lead to metabolic reprogramming, including both drug and device-based therapies such as cardiac resynchronization therapy (CRT) and left ventricular assist devices (LVADs).

Summary: Strategies to induce metabolic reprogramming in the diseased heart need further study. Future research should address differences in metabolic abnormalities in HFrEF and HFpEF, methods to study metabolic responses to therapies, and impact of metabolic reprogramming on clinical outcomes in heart failure.

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心力衰竭的代谢重编程：从能量饥饿到治疗靶点。

综述目的：本综述的目的是总结目前关于心力衰竭代谢异常的文献，并提出可以诱导代谢重编程的治疗方法，以使患病心脏受益。最近发现：对心力衰竭患者的心脏和骨骼肌代谢的分析揭示了一些异常，包括PCr/ATP比率降低（表明心肌能量储备减少）、底物利用改变和线粒体异常。非侵入性和侵入性心脏代谢研究方法的一些进展使得该领域最近做出了重要贡献。有希望的治疗策略包括转向增加酮类和脂肪酸的利用，靶向线粒体的生物发生和功能，以及激活促进代谢重塑的基因。目前的几种治疗方法导致代谢重编程，包括药物和器械治疗，如心脏再同步治疗（CRT）和左心室辅助装置（lvad）。摘要：诱导病变心脏代谢重编程的策略需要进一步研究。未来的研究应关注HFrEF和HFpEF代谢异常的差异，研究代谢对治疗反应的方法，以及代谢重编程对心力衰竭临床结果的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Treatment Options in Cardiovascular Medicine Medicine-Cardiology and Cardiovascular Medicine

CiteScore

2.00

自引率

0.00%

发文量

期刊介绍： This journal aims to review the most important, recently published treatment-related advances in cardiovascular medicine. By providing clear, insightful, balanced contributions by international experts, the journal intends to elucidate novel approaches to treatment in those affected by the spectrum of cardiovascular-related diseases and conditions. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as coronary artery disease, cerebrovascular disease and stroke, heart failure, pediatric and congenital heart disease, and valvular, myocardial, pericardial, and cardiopulmonary diseases. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known figures in the field, and an international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research.