Bioenergetics and Metabolic Changes in the Failing Heart

The Gift of Light

“…1 In the failing heart, there are changes in energy substrate metabolism whose causes and effects are poorly understood. 2 These changes may contribute to deterioration in cardiac contractility and to increasing LV remodeling that are the hallmarks of the failing heart. In HF following cardiac hypertrophy, there is a major metabolic switch in myocardial substrate metabolism from fatty acid to glucose oxidation.…”

“…In HF following cardiac hypertrophy, there is a major metabolic switch in myocardial substrate metabolism from fatty acid to glucose oxidation. [2][3][4][5] A key marker of this switch is the coordinated downregulation of fatty acid oxidation enzymes (eg, medium-chain acyl-CoA dehydrogenase and carnitine palmitoyltransferase-I β) and mRNA levels in the human LV with a concomitant increase in glucose uptake and oxidation. 2,6 This switch is thought to represent a metabolic reprogramming toward substrate metabolism that is more commonly seen in the fetal heart.…”

“…[2][3][4][5] A key marker of this switch is the coordinated downregulation of fatty acid oxidation enzymes (eg, medium-chain acyl-CoA dehydrogenase and carnitine palmitoyltransferase-I β) and mRNA levels in the human LV with a concomitant increase in glucose uptake and oxidation. 2,6 This switch is thought to represent a metabolic reprogramming toward substrate metabolism that is more commonly seen in the fetal heart. 7 The fetus in a womb uses glucose from the mother as the major substrate for energy production; in fact, ≈80% of fetal energy comes from glucose oxidation.…”