Alterations in Cardiac and Systemic Metabolism in Heart Failure

Area of Science:

• Cardiology
• Metabolic Science
• Biochemistry

Background:

• Altered cardiac and systemic metabolism characterize heart failure (HF).
• Cardiomyocytes in HF exhibit impaired substrate preference, mitochondrial function, and energy transfer.
• Systemic metabolic disruptions, including neurohormonal activation and comorbidities, impact HF progression.

Purpose of the Study:

• To review cardiac metabolism alterations in HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF).
• To examine the role of interorgan communication in myocardial function during HF.
• To highlight the metabolic mechanisms of novel HF therapies.

Main Methods:

• Literature review focusing on cardiac and systemic metabolism in HF.
• Comparative analysis of metabolic changes in HFrEF versus HFpEF.
• Discussion of emerging therapeutic strategies targeting metabolic pathways.

Main Results:

• HF involves distinct substrate metabolism alterations in HFrEF and HFpEF.
• Interorgan metabolic crosstalk significantly influences myocardial function in HF.
• Novel therapies like SGLT2 inhibitors and GLP-1 RAs show promise in restoring metabolic homeostasis.

Conclusions:

• Understanding cardiac metabolism is crucial for HF management.
• Targeting metabolic pathways offers a promising therapeutic avenue for HF.
• Restoration of metabolic homeostasis is a key mechanism for new HF treatments.