Abstract
Myocardial ischemia occurs for a mismatch between blood flow and metabolic requirements, when the rate of oxygen and metabolic substrates delivery to the myocardium is insufficient to meet the myocardial energy requirements for a given myocardial workload. During ischemia, substantial changes occur in cardiac energy metabolism, as a consequence of the reduced oxygen availability. Some of these metabolic changes are beneficial and may help the heart adapt to the ischemic condition. However, most of the changes are maladaptive and contribute to the severity of the ischemic injury leading stunned or hibernating myocardium, cell death and ultimately to contractile disfuction. Dramatic changes in cardiac metabolism and contractile function, also occur during myocardial reperfusion as a consequence of the generation of oxygen free radicals, loss of cation homeostasis, depletion of energy stores, and changes in subcellular activities. The reperfusion injury may cause in the death of cardiac myocytes that were still viable immediately before myocardial reperfusion. This form of myocardial injury, by itself can induce cardiomyocyte death and increase infarct size. During acute ischemia the relative substrate concentration is the prime factor defining preference and utilization rate. Allosteric enzyme regulation and protein phosphorylation cascades, partially controlled by hormones such as insulin, modulate the concentration effect; together they provide short-term adjustments of cardiac energy metabolism. The expression of metabolic genes is also dynamically regulated in response to developmental and (patho)physiological conditions, leading to long-term adjustments. Specific nuclear receptor transcription factors and co-activators regulate the expression of these genes. Understanding the functional role of these changes is critical for developing the concept of metabolic intervention for heart disease. The paper will review the alterations in energy metabolism that occur during acute and chronic ischemia.
Keywords: Cardiac metabolism, myocardial ischemia, oxidative phosphorylation, beta oxidation, glycolysis
Current Pharmaceutical Design
Title: Cardiac Metabolism in Myocardial Ischemia
Volume: 14 Issue: 25
Author(s): Giuseppe M.C. Rosano, Massimo Fini, Giuseppe Caminiti and Giuseppe Barbaro
Affiliation:
Keywords: Cardiac metabolism, myocardial ischemia, oxidative phosphorylation, beta oxidation, glycolysis
Abstract: Myocardial ischemia occurs for a mismatch between blood flow and metabolic requirements, when the rate of oxygen and metabolic substrates delivery to the myocardium is insufficient to meet the myocardial energy requirements for a given myocardial workload. During ischemia, substantial changes occur in cardiac energy metabolism, as a consequence of the reduced oxygen availability. Some of these metabolic changes are beneficial and may help the heart adapt to the ischemic condition. However, most of the changes are maladaptive and contribute to the severity of the ischemic injury leading stunned or hibernating myocardium, cell death and ultimately to contractile disfuction. Dramatic changes in cardiac metabolism and contractile function, also occur during myocardial reperfusion as a consequence of the generation of oxygen free radicals, loss of cation homeostasis, depletion of energy stores, and changes in subcellular activities. The reperfusion injury may cause in the death of cardiac myocytes that were still viable immediately before myocardial reperfusion. This form of myocardial injury, by itself can induce cardiomyocyte death and increase infarct size. During acute ischemia the relative substrate concentration is the prime factor defining preference and utilization rate. Allosteric enzyme regulation and protein phosphorylation cascades, partially controlled by hormones such as insulin, modulate the concentration effect; together they provide short-term adjustments of cardiac energy metabolism. The expression of metabolic genes is also dynamically regulated in response to developmental and (patho)physiological conditions, leading to long-term adjustments. Specific nuclear receptor transcription factors and co-activators regulate the expression of these genes. Understanding the functional role of these changes is critical for developing the concept of metabolic intervention for heart disease. The paper will review the alterations in energy metabolism that occur during acute and chronic ischemia.
Export Options
About this article
Cite this article as:
Rosano M.C. Giuseppe, Fini Massimo, Caminiti Giuseppe and Barbaro Giuseppe, Cardiac Metabolism in Myocardial Ischemia, Current Pharmaceutical Design 2008; 14 (25) . https://dx.doi.org/10.2174/138161208786071317
DOI https://dx.doi.org/10.2174/138161208786071317 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Transcranial Doppler Ultrasonography: Current Status
Current Medical Imaging Are Retinoids a Promise for Alzheimer’s Disease Management?
Current Medicinal Chemistry Recent Progress in Cerebrovascular Gene Therapy
Current Neurovascular Research Can Erythrocyte Catalase Regulate Blood Pressure?
Cardiovascular & Hematological Agents in Medicinal Chemistry Pharmacological Inhibition of Platelet Reactivity. Clinical and Pharmacodynamic Effects
Current Vascular Pharmacology Advances in Coronary Stent Technology - Active Drug-Loaded Stent Surfaces for Prevention of Restenosis and Improvement of Biocompatibility
Current Pharmaceutical Biotechnology Need for Ongoing Anti Arrhythmic Drugs After Ablation of Atrial Fibrillation. Review
Recent Patents on Cardiovascular Drug Discovery Patent Foramen Ovale, the Role of Antiplatelet Therapy Alone or Anticoagulant Therapy Alone Versus Device Closure for Cryptogenic Stroke: A Review of the Literature and Current Recommendations
Cardiovascular & Hematological Agents in Medicinal Chemistry Neuronal Regulation of Aortic Valve Cusps
Current Vascular Pharmacology Antisense Therapy for Cardiovascular Diseases
Current Pharmaceutical Design Gene Expression Profiling Analysis to Identify Key Genes and Underlying Mechanisms in Meniscus of Osteoarthritis Patients
Combinatorial Chemistry & High Throughput Screening Therapeutic Implications of Immune-endocrine Interactions in the Critically Ill Patients
Current Drug Targets - Immune, Endocrine & Metabolic Disorders Functional Foods: Salient Features and Clinical Applications
Current Drug Targets - Immune, Endocrine & Metabolic Disorders The Histamine H3 Receptor as a Therapeutic Drug Target for Metabolic Disorders: Status, Challenges and Opportunities
Current Topics in Medicinal Chemistry Stairway to Heaven or Hell? Perspectives and Limitations of Chagas Disease Chemotherapy
Current Topics in Medicinal Chemistry Estrogen Receptors as Targets for Drug Development for Breast Cancer, Osteoporosis and Cardiovascular Diseases
Current Cancer Drug Targets Asymmetric Dimethylarginine: a Key Player in the Pathophysiology of Endothelial Dysfunction, Vascular Inflammation and Atherosclerosis in Rheumatoid Arthritis?
Current Pharmaceutical Design Effects of Statins on Blood Pressure: A Review of the Experimental and Clinical Evidence.
Current Vascular Pharmacology Parathyroid Hypertension: A Rare, but Curable form of Secondary Hypertension
Current Hypertension Reviews MicroRNA-30 and 145 as Targets for the Treatment of Cardiovascular Diseases: Therapeutic Feasibility and Challenges
Current Pharmaceutical Design