Metabolic impairment in heart failure The myocardial and systemic perspective

Doehner, Wolfram, Frenneaux, Michael and Anker, Stefan D. (2014) Metabolic impairment in heart failure The myocardial and systemic perspective. Journal of the American College of Cardiology, 64 (13). pp. 1388-1400. ISSN 0735-1097

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Although bioenergetic starvation is not a new concept in heart failure (HF), recent research has led to a growing appreciation of the complexity of metabolic aspects of HF pathophysiology. All steps of energy extraction, transfer, and utilization are affected, and structural metabolism is impaired, leading to compromised functional integrity of tissues. Not only the myocardium, but also peripheral tissues and organs are affected by metabolic failure, resulting in a global imbalance between catabolic and anabolic signals, leading to tissue wasting and, ultimately, to cachexia. Metabolic feedback signals from muscle and fat actively contribute to further myocardial strain, promoting disease progression. The prolonged survival of patients with stable, compensated HF will increasingly bring chronic metabolic complications of HF to the fore and gradually shift its clinical presentation. This paper reviews recent evidence on myocardial and systemic metabolic impairment in HF and summarizes current and emerging therapeutic concepts with specific metabolic targets.

Item Type: Article
Uncontrolled Keywords: cachexia,insulin resistance,metabolism,muscle,sacrcopenia,stroke
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health
Depositing User: Pure Connector
Date Deposited: 25 Feb 2015 06:14
Last Modified: 04 Jul 2023 09:30
DOI: 10.1016/j.jacc.2014.04.083

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