Research progress on metabolic abnormalities in myocardial hypertrophy

Area of Science:

• Cardiology
• Metabolomics
• Molecular Biology

Background:

• Myocardial hypertrophy, initially adaptive, becomes detrimental with persistent stress, raising risks of heart failure and death.
• Metabolic remodeling is a key early driver of myocardial hypertrophy, not just a consequence of increased workload.

Purpose of the Study:

• To review recent advances in metabolic abnormalities in myocardial hypertrophy.
• To focus on pathophysiological mechanisms, biomarker implications, therapeutic opportunities, and future research directions.

Main Methods:

• Review of current evidence on metabolic alterations in hypertrophic myocardium.
• Analysis of interactions between metabolic abnormalities and cellular growth pathways.
• Evaluation of metabolomics in biomarker research for hypertrophy.

Main Results:

• Hypertrophic hearts show impaired fatty acid oxidation, increased glycolysis, mitochondrial defects, NAD+-sirtuin disruption, redox stress, and altered amino acid/ketone metabolism.
• Metabolomics offers integrated biomarker panels, but interpretation is complex and context-dependent.
• Emerging therapies target specific metabolic pathways, requiring biomarker-guided clinical trials.

Conclusions:

• Metabolic abnormalities are central to myocardial hypertrophy pathogenesis and progression.
• Biomarker-guided, phenotype-specific therapies hold promise but require further validation.
• Addressing challenges in distinguishing adaptive vs. maladaptive remodeling and harmonizing multi-omics data is crucial for future progress.