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Emerging therapy strategies for energy metabolism in acute myocardial infarction

Ruixin Ma1,2,3,4,5, Dazhou Lu1,2,3,4,5, Zeyu Yang1,2,3,4,5

  • 1Department of Emergency Medicine, Qilu Hospital of Shandong University, Jinan, 250012, China.

Journal of Translational Medicine
|October 22, 2025
PubMed

Insights

Acute myocardial infarction (AMI) triggers heart cell injury via disrupted energy metabolism. Targeting metabolic reprogramming and mitochondrial function shows promise for treating ischaemia-reperfusion injury (IRI) and improving outcomes.

Area of Science:

  • Cardiovascular Medicine
  • Cellular Metabolism
  • Biochemistry

Background:

  • Acute myocardial infarction (AMI) causes irreversible cardiomyocyte injury due to ischaemia and hypoxia.
  • Ischaemia-reperfusion injury (IRI) exacerbates complications like arrhythmias and heart failure post-AMI.
  • Myocardial energy metabolism is critically disrupted during AMI and IRI.

Purpose of the Study:

  • To review the role of myocardial energy metabolism in AMI pathogenesis.
  • To explore mechanisms of cellular injury during ischaemia-reperfusion.
  • To discuss emerging therapeutic strategies for mitigating IRI.

Main Methods:

  • Literature review integrating preclinical and clinical evidence.
  • Focus on dysregulation of fatty acid oxidation, glycolysis, and mitochondrial function.
  • Analysis of key injury mechanisms: ROS overproduction, succinate accumulation, mPTP opening.

Main Results:

  • AMI disrupts myocardial energy metabolism, impacting FAO, glycolysis, and mitochondrial function.
  • ROS, succinate accumulation, and mPTP opening are key drivers of IRI.
  • Metabolic reprogramming, mitochondrial protection, and ischaemic conditioning are promising therapeutic avenues.

Conclusions:

  • Metabolic modulation is a significant approach to mitigate IRI in AMI.
  • Targeting cellular energy pathways offers potential for improved patient outcomes.
  • Further research into metabolic interventions is warranted for AMI treatment.

Keywords:
Cardiac metabolismEnergy metabolismMyocardial infarction

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