Metabolic-Electrophysiological Coupling in Heart Failure: from Bidirectional Decoupling to Therapeutic Recoupling
Hong Yu1, Shi-Yao Chang1, Xin Tian2
1Graduate School, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi Province, 330006, China.
Insights
Disrupted heart electrophysiology and metabolism coupling worsens heart failure. Targeting this link with new therapies may improve heart function and patient outcomes.
Area of Science:
- Cardiology
- Molecular Biology
- Biochemistry
Background:
- Heart failure (HF) is a major global health issue characterized by progressive cardiac dysfunction.
- The interplay between cardiomyocyte electrical activity and energy metabolism is vital for maintaining heart function.
- Dysfunctional coupling of these processes contributes significantly to HF progression.
Purpose of the Study:
- To review the role of disrupted metabolic-electrophysiological coupling in heart failure.
- To identify and summarize emerging therapeutic targets for HF based on this coupling.
Main Methods:
- Literature review of current research on cardiac electrophysiology and metabolism in HF.
- Analysis of preclinical and clinical studies on therapeutic interventions targeting electro-metabolic coupling.
Main Results:
- Evidence supports the critical role of electro-metabolic coupling in HF.
- Current therapies targeting electrical or metabolic pathways show efficacy.
- Foundational research validates the concept of targeting electro-metabolic crosstalk for HF treatment.
Conclusions:
- Restoring the integration between cardiac metabolism and electrophysiology is a promising therapeutic strategy for HF.
- Interventions like metabolic modulators and mitochondrially targeted agents show potential.
- An integrated approach targeting electro-metabolic coupling may improve HF patient outcomes.
Purpose Of Review:
Heart failure (HF) is a complex clinical syndrome of progressive cardiac dysfunction, posing a major global burden on public health. The coupling between cardiomyocyte electrophysiology and energy metabolism is critical for sustaining cardiac electromechanical function. This review aims to elucidate the role of disrupted metabolic-electrophysiological coupling in disease progression and summarize emerging therapeutic targets.
Recent Findings:
Currently, drugs that correct electrical or metabolic issues are proving effective in patients, while theoretical research and preliminary experiments have corroborated electro-metabolic coupling and its regulatory crosstalk among metabolic signaling, electrical activity, and energy utilization. These foundational studies have established a viable basis for multi-target interventions in HF. Restoring the disrupted integration between metabolism and electrophysiology emerges as a promising strategic direction in HF therapy. Interventions targeting this integration, such as metabolic modulators and mitochondrially targeted agents, may suppress arrhythmias, reverse adverse remodeling, and improve contractile function. This integrated approach may ultimately lead to more effective treatments that improve clinical outcomes for HF patients.
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