Myocardial metabolism in heart failure: Purinergic signalling and other metabolic concepts

Pharmacology & Therapeutics
Andreas L BirkenfeldGeoffrey Burnstock

Abstract

Despite significant therapeutic advances in heart failure (HF) therapy, the morbidity and mortality associated with this disease remains unacceptably high. The concept of metabolic dysfunction as an important underlying mechanism in HF is well established. Cardiac function is inextricably linked to metabolism, with dysregulation of cardiac metabolism pathways implicated in a range of cardiac complications, including HF. Modulation of cardiac metabolism has therefore become an attractive clinical target. Cardiac metabolism is based on the integration of adenosine triphosphate (ATP) production and utilization pathways. ATP itself impacts the heart not only by providing energy, but also represents a central element in the purinergic signaling pathway, which has received considerable attention in recent years. Furthermore, novel drugs that have received interest in HF include angiotensin receptor blocker-neprilysin inhibitor (ARNi) and sodium glucose cotransporter 2 (SGLT-2) inhibitors, whose favorable cardiovascular profile has been at least partly attributed to their effects on metabolism. This review, describes the major metabolic pathways and concepts of the healthy heart (including fatty acid oxidation, glycolysis, Krebs cycle...Continue Reading

Citations

Jun 23, 2020·Oxidative Medicine and Cellular Longevity·Junteng ZhouXiaojing Liu
Dec 29, 2019·Pharmacological Reviews·Tina SchumannAndreas L Birkenfeld
Jan 2, 2021·International Journal of Molecular Sciences·Katarina AndelovaNarcis Tribulova
Jul 1, 2020·American Journal of Physiology. Endocrinology and Metabolism·Íngrid Martí-PàmiesMarielle Scherrer-Crosbie
Oct 23, 2020·Canadian Journal of Physiology and Pharmacology·Xilan TangMorris Karmazyn
May 25, 2021·Frontiers in Cardiovascular Medicine·Zhiwei LiJing Wang
Jun 8, 2021·Acta Pharmaceutica Sinica. B·Yanan HeDingkun Zhang
Jul 25, 2021·International Journal of Environmental Research and Public Health·Weronika WasylukAgnieszka Zwolak

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