Irisin: linking metabolism with heart failure

The heart is an organ with extremely high energy expenditure, and cardiac performance is consistent with its metabolic level. Under pathological situations, the heart adjusts its metabolic pattern through mitochondrial regulation and substrate selection to maintain energy homeostasis. Heart failure is associated with impaired cardiac energy production, transduction or utilization. Reduced exercise tolerance, skeletal muscle dystrophy and even cardiac cachexia are commonly found in patients with advanced heart failure. Irisin is a newly identified myokine and is mainly secreted by skeletal muscles after exercise. Irisin regulates metabolism and plays essential roles in the development of metabolic diseases. The heart is another abundant source of irisin synthesis and secretion other than skeletal muscle. However, the functions of irisin in the heart have not been completely elucidated. This review introduces the current understanding of the physiological role of irisin, alteration of irisin levels in heart failure, possible mechanisms of irisin in metabolic remodeling and cardiac hypertrophy, and perspectives of irisin serving as a novel target in the management of heart failure.