Cardiac Energy Metabolism: A Potential Novel Therapeutic Target in the Treatment of Ischemic Heart Diseases

Abstract

Despite decades of research, ischemic heart diseases (IHD) remain a major health problem in Jordan and worldwide. Ischemia is associated with serious and deleterious perturbations in biochemical, and functional characteristics of the heart. During ischemia, the heart increased it is reliance on glycolysis as an ultimate source for ATP production. However, fatty acid β-oxidation rates significantly increased at reperfusion. The metabolic dysregulation negatively impact both cardiac function and efficiency. Current treatment approaches of IHD mostly focus on increasing oxygen supply (e.g. thrombolytic agents) or decreasing oxygen demand (e.g. beta-blockers). However, therapeutic interventions aiming at improving cardiac efficiency of oxygen utilization have not gained enough interest. In this review, this review focused on the metabolic pathways of fatty acid and glucose oxidation, as well as the metabolic phenotype of the ischemic heart. Furthermore, this review will discuss the mechanisms of metabolic modulators and how they can improve cardiac function in ischemia-reperfusion condition.