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Energy metabolism and redox balance: How phytochemicals influence heart failure treatment - 04/02/24

Doi : 10.1016/j.biopha.2024.116136 
Cong Chen a, 1, Jie Wang a, , Xueying Zhu b, 1, Jun Hu a, Chao Liu a, Lanchun Liu a
a Guang’anmen Hospital, China Academy of Chinese Medicine Sciences, Beijing 100053, China 
b Department of Anatomy, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 102488, China 

Corresponding author.

Abstract

Heart Failure (HF) epitomizes a formidable global health quandary characterized by marked morbidity and mortality. It has been established that severe derangements in energy metabolism are central to the pathogenesis of HF, culminating in an inadequate cardiac energy milieu, which, in turn, precipitates cardiac pump dysfunction and systemic energy metabolic failure, thereby steering the trajectory and potential recuperation of HF. The conventional therapeutic paradigms for HF predominantly target amelioration of heart rate, and cardiac preload and afterload, proffering symptomatic palliation or decelerating the disease progression. However, the realm of therapeutics targeting the cardiac energy metabolism remains largely uncharted. This review delineates the quintessential characteristics of cardiac energy metabolism in healthy hearts, and the metabolic aberrations observed during HF, alongside the associated metabolic pathways and targets. Furthermore, we delve into the potential of phytochemicals in rectifying the redox disequilibrium and the perturbations in energy metabolism observed in HF. Through an exhaustive analysis of recent advancements, we underscore the promise of phytochemicals in modulating these pathways, thereby unfurling a novel vista on HF therapeutics. Given their potential in orchestrating cardiac energy metabolism, phytochemicals are emerging as a burgeoning frontier for HF treatment. The review accentuates the imperative for deeper exploration into how these phytochemicals specifically intervene in cardiac energy metabolism, and the subsequent translation of these findings into clinical applications, thereby broadening the horizon for HF treatment modalities.

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Highlights

The onset of Heart Failure (HF) is closely associated with alterations in mitochondrial function and metabolic remodeling in cardiac cells, with fluctuations in redox reactions playing a pivotal role in these mitochondrial functional changes.
Natural constituents like polyphenols, saponins, polysaccharides, and alkaloids, recognized as innate antioxidants, have shown promise in alleviating HF symptoms through the modulation of energy metabolism, opening avenues for supplementary and alternative therapeutic approaches in HF treatment.
The redox disequilibrium in HF significantly impacts cardiac fuel and energy metabolism, which in turn precipitates cardiac functional detriment and failure, underscoring the importance of understanding redox balance in developing novel therapeutic strategies.
While phytochemicals emerge as potential regulators of cardiac energy metabolism, offering a new direction in HF therapeutics, the clinical investigation of these natural products is still in its nascent stage, necessitating further research to evaluate their safety, effectiveness, and the mechanisms underlying their therapeutic efficacy in HF.
Future research directions should aim at a deeper understanding of how phytochemicals intervene in cardiac energy metabolism, and the evaluation of their safety and effectiveness in actual clinical applications, alongside exploring the potential effects and inherent risks associated with the combined application of these natural products with existing treatment modalities.

Le texte complet de cet article est disponible en PDF.

Abbreviations : AcAc, ACADL, ADP, AKBA, AMPK, AMPKα2, AMI, BCAA, CAD, CPT, CPT-1α, Cyt-c, DCM, Drp1, ETC, FAO, FATP-1, G-Rb3, G-Rg1, G-Rg3, G6P, GLUT1, GLUT4, GSH, GSRd, GRb1, H/R, HF, HFrEF, HG, HG/PA, HSYA, HUVECs, I/R, IMM, IRS, LPL, MCU, ME1, MI, Mfn1/2, MPC, mtDNA, mTOR, mPTP, NADH, NO, NNT, OMM, OP-D, OPA1, OXPHOS, PDK4, PDH, PGC1, p70S6K1, PI3K, PNS, PPARα, SIRTs, SR, TCA, VA, VDAC1, βOHB

Keywords : Heart failure, Energy metabolism, Phytochemicals, Mitochondria, Glucose oxidation


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Vol 171

Article 116136- février 2024 Retour au numéro
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