在HFpEF中衰老和代谢:病理生理学和治疗影响
Min Ye1, Shenghui Feng2, Zixuan Xu3
1Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China; Department of Medical Ultrasonics, Institute for Diagnostic and Interventional Ultrasound, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
Metabolism: clinical and experimental
|December 6, 2025
概括
保存喷射分数的心力衰竭 (HFpEF) 是一种与年龄相关的综合征,由代谢和线粒体功能障碍驱动. 针对这些途径的干预措施,如NAD+前体和SGLT2抑制剂,有望改善HFpEF.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 代谢医学是一种代谢医学.
背景情况:
- 在老年人群中,心力衰竭与保存的喷射分数 (HFpEF) 是普遍存在的.
- HFpEF涉及透支功能障碍,并保留了心功能.
- 衰老会影响心肌能量代谢,增加对HFpEF的敏感性.
研究的目的:
- 审查与衰老相关的代谢和线粒体功能障碍在HFpEF中的作用.
- 突出针对这些途径的潜在治疗策略.
主要方法:
- 对HFpEF病原和治疗的临床前和临床研究的综述.
- 对与年龄有关的心脏功能障碍背后的分子和细胞机制的分析.
- 在HFpEF中检查代谢重编程和线粒体效率.
主要成果:
- 衰老会减少脂肪酸的氧化,损害pyruvate的氧化,导致能量效率低下.
- 线粒体缺陷 (减少生物发生,NAD+耗尽,电子运输受损) 会加剧HFpEF.
- 炎症和蛋白质静止崩导致心肌纤维化和硬.
- NAD+前体,mTORC1抑制剂和β-甲酸显示出临床前的前景.
- SGLT2抑制剂和GLP-1受体激动剂在HFpEF中提供临床益处.
结论:
- 代谢和线粒体失调是老化中的HFpEF病原体的核心.
- 针对这些与年龄相关的途径为HFpEF提供了一个有希望的治疗前沿.
- 机械定制的干预措施对于管理这种复杂的综合症至关重要.
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