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Department of Physiology and Biophysics, School of Medicine, Case Western Reserve University, Cleveland, Ohio; Scuola Superiore Sant'Anna, Pisa, Italy; Department of Physiology, New York Medical College, Valhalla, New York; and Department of Pediatrics, University of Alberta, Edmonton, Canada
The alterations in myocardial energy substrate metabolism that occur in heart failure, and the causes and consequences of these abnormalities, are poorly understood. There is evidence to suggest that impaired substrate metabolism contributes to contractile dysfunction and to the progressive left ventricular remodeling that are characteristic of the heart failure state. The general concept that has recently emerged is that myocardial substrate selection is relatively normal during the early stages of heart failure; however, in the advanced stages there is a downregulation in fatty acid oxidation, increased glycolysis and glucose oxidation, reduced respiratory chain activity, and an impaired reserve for mitochondrial oxidative flux. This review discusses 1) the metabolic changes that occur in chronic heart failure, with emphasis on the mechanisms that regulate the changes in the expression of metabolic genes and the function of metabolic pathways; 2) the consequences of these metabolic changes on cardiac function; 3) the role of changes in myocardial substrate metabolism on ventricular remodeling and disease progression; and 4) the therapeutic potential of acute and long-term manipulation of cardiac substrate metabolism in heart failure.
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J. H. Rennison, T. A. McElfresh, I. C. Okere, E. J. Vazquez, H. V. Patel, A. B. Foster, K. K. Patel, Q. Chen, B. D. Hoit, K.-Y. Tserng, et al. High-fat diet postinfarction enhances mitochondrial function and does not exacerbate left ventricular dysfunction Am J Physiol Heart Circ Physiol, March 1, 2007; 292(3): H1498 - H1506. [Abstract] [Full Text] [PDF] |
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N. Sharma, I. C. Okere, M. K. Duda, D. J. Chess, K. M. O'Shea, and W. C. Stanley Potential impact of carbohydrate and fat intake on pathological left ventricular hypertrophy Cardiovasc Res, January 15, 2007; 73(2): 257 - 268. [Abstract] [Full Text] [PDF] |
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C. D.L. Folmes and G. D. Lopaschuk Role of malonyl-CoA in heart disease and the hypothalamic control of obesity Cardiovasc Res, January 15, 2007; 73(2): 278 - 287. [Abstract] [Full Text] [PDF] |
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J. Satrustegui, B. Pardo, and A. del Arco Mitochondrial Transporters as Novel Targets for Intracellular Calcium Signaling Physiol Rev, January 1, 2007; 87(1): 29 - 67. [Abstract] [Full Text] [PDF] |
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R. Southworth, K. A. B. Davey, A. Warley, and P. B. Garlick A reevaluation of the roles of hexokinase I and II in the heart Am J Physiol Heart Circ Physiol, January 1, 2007; 292(1): H378 - H386. [Abstract] [Full Text] [PDF] |
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I. Shiojima and K. Walsh Regulation of cardiac growth and coronary angiogenesis by the Akt/PKB signaling pathway Genes & Dev., December 15, 2006; 20(24): 3347 - 3365. [Abstract] [Full Text] [PDF] |
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V. Saks, R. Favier, R. Guzun, U. Schlattner, and T. Wallimann Molecular system bioenergetics: regulation of substrate supply in response to heart energy demands J. Physiol., December 15, 2006; 577(3): 769 - 777. [Abstract] [Full Text] [PDF] |
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