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Metabolic Therapies for Heart Failure

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Endocrinology and Metabolism".

Deadline for manuscript submissions: closed (31 May 2022) | Viewed by 56890

Special Issue Editor


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Guest Editor
INSERM Research Unit on Signaling and Cardiovascular Pathophysiology, Paris-Saclay University, Châtenay-Malabry, France
Interests: heart failure; dilated cardiomyopathy; NAD signaling; cardiac bioenergetics; mitochondrial function

Special Issue Information

Dear Colleagues,

Heart failure (HF) is a debilitating syndrome associated with the inability of the cardiac pump to deliver enough oxygen and nutrients to the peripheral organs and is accompanied by a high risk of arrhythmia and sudden death. Strongly associated with age, vascular and metabolic comorbidities and sedentary way of life, HF prevalence is fated to rise with the aging of the world population. Currently, even with optimal treatment, mortality rates remain close to 40% at 5 years after prognosis. There is thus an urgent need for new approaches to halt or reverse the course of ventricular dysfunction leading to terminal HF.

This Special Issue focuses on recent developments in the field of metabolic therapies aimed at correcting the metabolic perturbations that characterize the failing heart. These perturbations include inflexibility in the use of energy substrates, severe mitochondrial dysfunction and increased oxidative stress. They all have major consequences not only for cardiac contractility and ion homeostasis but also for cardiac cell survival, intracellular signaling and epigenetic regulation of gene expression. Hence, metabolic therapies can potentially have a broad impact on cardiac physiology, and a combination of many different types of expertise is required to assess their efficacy and safety for the treatment of patients with heart failure.

We warmly welcome the submission of original papers and reviews on new therapeutic strategies addressing these key issues.

Dr. Mathias Mericskay
Guest Editor

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Keywords

  • Heart failure
  • Metabolic therapy
  • Nutrition therapy
  • Energy metabolism
  • Mitochondrial function
  • Oxidative stress
  • Autophagy
  • Coenzyme metabolism
  • Glucose metabolism
  • Fatty acid metabolism
  • Ketone body metabolism
  • Insulin signaling
  • Energy-sensing signaling pathways
  • Redox-sensing signaling pathways

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Published Papers (8 papers)

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Research

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7 pages, 761 KiB  
Communication
Implications of a Soy-Based Diet for Animal Models
by Justine Dhot, Valentine Prat, Marine Ferron, Virginie Aillerie, Angélique Erraud, Bertrand Rozec, Michel De Waard, Chantal Gauthier and Benjamin Lauzier
Int. J. Mol. Sci. 2021, 22(2), 774; https://doi.org/10.3390/ijms22020774 - 14 Jan 2021
Cited by 2 | Viewed by 2089
Abstract
The use of animal models in fundamental or pre-clinical research remains an absolute requirement for understanding human pathologies and developing new drugs. In order to transpose these results into clinical practice, many parameters must be taken into account to limit bias. Attention has [...] Read more.
The use of animal models in fundamental or pre-clinical research remains an absolute requirement for understanding human pathologies and developing new drugs. In order to transpose these results into clinical practice, many parameters must be taken into account to limit bias. Attention has recently been focused on the sex, age or even strain of each animal, but the impact of diet has been largely neglected. Soy, which is commonly used in the diet in varying quantities can affect their physiology. In order to assess whether the presence of soy can impact the obtained results, we studied the impact of a soy-based diet versus a soy-free diet, on diastolic function in a rat model based on transgenic overexpression of the β3-adrenergic receptors in the endothelium and characterized by the appearance of diastolic dysfunction with age. Our results show that the onset of diastolic dysfunction is only observed in transgenic male rats fed with a soy-free diet in the long term. Our study highlights the importance of the diet’s choice in the study design process, especially regarding the proportion of soy, to correctly interpret the outcome as low-cost diets are more likely to be highly concentrated in soy. Full article
(This article belongs to the Special Issue Metabolic Therapies for Heart Failure)
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Review

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18 pages, 1846 KiB  
Review
Heart Failure and Drug Therapies: A Metabolic Review
by Frank Yu, Bianca McLean, Mitesh Badiwala and Filio Billia
Int. J. Mol. Sci. 2022, 23(6), 2960; https://doi.org/10.3390/ijms23062960 - 9 Mar 2022
Cited by 11 | Viewed by 5530
Abstract
Cardiovascular disease is the leading cause of mortality globally with at least 26 million people worldwide living with heart failure (HF). Metabolism has been an active area of investigation in the setting of HF since the heart demands a high rate of ATP [...] Read more.
Cardiovascular disease is the leading cause of mortality globally with at least 26 million people worldwide living with heart failure (HF). Metabolism has been an active area of investigation in the setting of HF since the heart demands a high rate of ATP turnover to maintain homeostasis. With the advent of -omic technologies, specifically metabolomics and lipidomics, HF pathologies have been better characterized with unbiased and holistic approaches. These techniques have identified novel pathways in our understanding of progression of HF and potential points of intervention. Furthermore, sodium-glucose transport protein 2 inhibitors, a drug that has changed the dogma of HF treatment, has one of the strongest types of evidence for a potential metabolic mechanism of action. This review will highlight cardiac metabolism in both the healthy and failing heart and then discuss the metabolic effects of heart failure drugs. Full article
(This article belongs to the Special Issue Metabolic Therapies for Heart Failure)
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28 pages, 2686 KiB  
Review
Mitochondrial-Targeted Therapy for Doxorubicin-Induced Cardiotoxicity
by Bin Bin Wu, Kam Tong Leung and Ellen Ngar-Yun Poon
Int. J. Mol. Sci. 2022, 23(3), 1912; https://doi.org/10.3390/ijms23031912 - 9 Feb 2022
Cited by 82 | Viewed by 11302
Abstract
Anthracyclines, such as doxorubicin, are effective chemotherapeutic agents for the treatment of cancer, but their clinical use is associated with severe and potentially life-threatening cardiotoxicity. Despite decades of research, treatment options remain limited. The mitochondria is commonly considered to be the main target [...] Read more.
Anthracyclines, such as doxorubicin, are effective chemotherapeutic agents for the treatment of cancer, but their clinical use is associated with severe and potentially life-threatening cardiotoxicity. Despite decades of research, treatment options remain limited. The mitochondria is commonly considered to be the main target of doxorubicin and mitochondrial dysfunction is the hallmark of doxorubicin-induced cardiotoxicity. Here, we review the pathogenic mechanisms of doxorubicin-induced cardiotoxicity and present an update on cardioprotective strategies for this disorder. Specifically, we focus on strategies that can protect the mitochondria and cover different therapeutic modalities encompassing small molecules, post-transcriptional regulators, and mitochondrial transfer. We also discuss the shortcomings of existing models of doxorubicin-induced cardiotoxicity and explore advances in the use of human pluripotent stem cell derived cardiomyocytes as a platform to facilitate the identification of novel treatments against this disorder. Full article
(This article belongs to the Special Issue Metabolic Therapies for Heart Failure)
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17 pages, 1295 KiB  
Review
Therapeutic Targets for DOX-Induced Cardiomyopathy: Role of Apoptosis vs. Ferroptosis
by Hiroki Kitakata, Jin Endo, Hidehiko Ikura, Hidenori Moriyama, Kohsuke Shirakawa, Yoshinori Katsumata and Motoaki Sano
Int. J. Mol. Sci. 2022, 23(3), 1414; https://doi.org/10.3390/ijms23031414 - 26 Jan 2022
Cited by 75 | Viewed by 9771
Abstract
Doxorubicin (DOX) is the most widely used anthracycline anticancer agent; however, its cardiotoxicity limits its clinical efficacy. Numerous studies have elucidated the mechanisms underlying DOX-induced cardiotoxicity, wherein apoptosis has been reported as the most common final step leading to cardiomyocyte death. However, in [...] Read more.
Doxorubicin (DOX) is the most widely used anthracycline anticancer agent; however, its cardiotoxicity limits its clinical efficacy. Numerous studies have elucidated the mechanisms underlying DOX-induced cardiotoxicity, wherein apoptosis has been reported as the most common final step leading to cardiomyocyte death. However, in the past two years, the involvement of ferroptosis, a novel programmed cell death, has been proposed. The purpose of this review is to summarize the historical background that led to each form of cell death, focusing on DOX-induced cardiotoxicity and the molecular mechanisms that trigger each form of cell death. Furthermore, based on this understanding, possible therapeutic strategies to prevent DOX cardiotoxicity are outlined. DNA damage, oxidative stress, intracellular signaling, transcription factors, epigenetic regulators, autophagy, and metabolic inflammation are important factors in the molecular mechanisms of DOX-induced cardiomyocyte apoptosis. Conversely, the accumulation of lipid peroxides, iron ion accumulation, and decreased expression of glutathione and glutathione peroxidase 4 are important in ferroptosis. In both cascades, the mitochondria are an important site of DOX cardiotoxicity. The last part of this review focuses on the significance of the disruption of mitochondrial homeostasis in DOX cardiotoxicity. Full article
(This article belongs to the Special Issue Metabolic Therapies for Heart Failure)
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15 pages, 331 KiB  
Review
Heart Failure after Cardiac Surgery: The Role of Halogenated Agents, Myocardial Conditioning and Oxidative Stress
by José Luis Guerrero-Orriach, Maria Dolores Carmona-Luque and Laura Gonzalez-Alvarez
Int. J. Mol. Sci. 2022, 23(3), 1360; https://doi.org/10.3390/ijms23031360 - 25 Jan 2022
Cited by 14 | Viewed by 3412
Abstract
Heart disease requires a surgical approach sometimes. Cardiac-surgery patients develop heart failure associated with ischemia induced during extracorporeal circulation. This complication could be decreased with anesthetic drugs. The cardioprotective effects of halogenated agents are based on pre- and postconditioning (sevoflurane, desflurane, or isoflurane) [...] Read more.
Heart disease requires a surgical approach sometimes. Cardiac-surgery patients develop heart failure associated with ischemia induced during extracorporeal circulation. This complication could be decreased with anesthetic drugs. The cardioprotective effects of halogenated agents are based on pre- and postconditioning (sevoflurane, desflurane, or isoflurane) compared to intravenous hypnotics (propofol). We tried to put light on the shadows walking through the line of the halogenated anesthetic drugs’ effects in several enzymatic routes and oxidative stress, waiting for the final results of the ACDHUVV-16 clinical trial regarding the genetic modulation of this kind of drugs. Full article
(This article belongs to the Special Issue Metabolic Therapies for Heart Failure)
30 pages, 2671 KiB  
Review
Metabolic Therapy of Heart Failure: Is There a Future for B Vitamins?
by Jérôme Piquereau, Solène E. Boitard, Renée Ventura-Clapier and Mathias Mericskay
Int. J. Mol. Sci. 2022, 23(1), 30; https://doi.org/10.3390/ijms23010030 - 21 Dec 2021
Cited by 20 | Viewed by 5703
Abstract
Heart failure (HF) is a plague of the aging population in industrialized countries that continues to cause many deaths despite intensive research into more effective treatments. Although the therapeutic arsenal to face heart failure has been expanding, the relatively short life expectancy of [...] Read more.
Heart failure (HF) is a plague of the aging population in industrialized countries that continues to cause many deaths despite intensive research into more effective treatments. Although the therapeutic arsenal to face heart failure has been expanding, the relatively short life expectancy of HF patients is pushing towards novel therapeutic strategies. Heart failure is associated with drastic metabolic disorders, including severe myocardial mitochondrial dysfunction and systemic nutrient deprivation secondary to severe cardiac dysfunction. To date, no effective therapy has been developed to restore the cardiac energy metabolism of the failing myocardium, mainly due to the metabolic complexity and intertwining of the involved processes. Recent years have witnessed a growing scientific interest in natural molecules that play a pivotal role in energy metabolism with promising therapeutic effects against heart failure. Among these molecules, B vitamins are a class of water soluble vitamins that are directly involved in energy metabolism and are of particular interest since they are intimately linked to energy metabolism and HF patients are often B vitamin deficient. This review aims at assessing the value of B vitamin supplementation in the treatment of heart failure. Full article
(This article belongs to the Special Issue Metabolic Therapies for Heart Failure)
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31 pages, 1390 KiB  
Review
Targeting Adrenergic Receptors in Metabolic Therapies for Heart Failure
by Dianne M. Perez
Int. J. Mol. Sci. 2021, 22(11), 5783; https://doi.org/10.3390/ijms22115783 - 28 May 2021
Cited by 14 | Viewed by 7937
Abstract
The heart has a reduced capacity to generate sufficient energy when failing, resulting in an energy-starved condition with diminished functions. Studies have identified numerous changes in metabolic pathways in the failing heart that result in reduced oxidation of both glucose and fatty acid [...] Read more.
The heart has a reduced capacity to generate sufficient energy when failing, resulting in an energy-starved condition with diminished functions. Studies have identified numerous changes in metabolic pathways in the failing heart that result in reduced oxidation of both glucose and fatty acid substrates, defects in mitochondrial functions and oxidative phosphorylation, and inefficient substrate utilization for the ATP that is produced. Recent early-phase clinical studies indicate that inhibitors of fatty acid oxidation and antioxidants that target the mitochondria may improve heart function during failure by increasing compensatory glucose oxidation. Adrenergic receptors (α1 and β) are a key sympathetic nervous system regulator that controls cardiac function. β-AR blockers are an established treatment for heart failure and α1A-AR agonists have potential therapeutic benefit. Besides regulating inotropy and chronotropy, α1- and β-adrenergic receptors also regulate metabolic functions in the heart that underlie many cardiac benefits. This review will highlight recent studies that describe how adrenergic receptor-mediated metabolic pathways may be able to restore cardiac energetics to non-failing levels that may offer promising therapeutic strategies. Full article
(This article belongs to the Special Issue Metabolic Therapies for Heart Failure)
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47 pages, 753 KiB  
Review
Nutraceutical, Dietary, and Lifestyle Options for Prevention and Treatment of Ventricular Hypertrophy and Heart Failure
by Mark F. McCarty
Int. J. Mol. Sci. 2021, 22(7), 3321; https://doi.org/10.3390/ijms22073321 - 24 Mar 2021
Cited by 20 | Viewed by 9633
Abstract
Although well documented drug therapies are available for the management of ventricular hypertrophy (VH) and heart failure (HF), most patients nonetheless experience a downhill course, and further therapeutic measures are needed. Nutraceutical, dietary, and lifestyle measures may have particular merit in this regard, [...] Read more.
Although well documented drug therapies are available for the management of ventricular hypertrophy (VH) and heart failure (HF), most patients nonetheless experience a downhill course, and further therapeutic measures are needed. Nutraceutical, dietary, and lifestyle measures may have particular merit in this regard, as they are currently available, relatively safe and inexpensive, and can lend themselves to primary prevention as well. A consideration of the pathogenic mechanisms underlying the VH/HF syndrome suggests that measures which control oxidative and endoplasmic reticulum (ER) stress, that support effective nitric oxide and hydrogen sulfide bioactivity, that prevent a reduction in cardiomyocyte pH, and that boost the production of protective hormones, such as fibroblast growth factor 21 (FGF21), while suppressing fibroblast growth factor 23 (FGF23) and marinobufagenin, may have utility for preventing and controlling this syndrome. Agents considered in this essay include phycocyanobilin, N-acetylcysteine, lipoic acid, ferulic acid, zinc, selenium, ubiquinol, astaxanthin, melatonin, tauroursodeoxycholic acid, berberine, citrulline, high-dose folate, cocoa flavanols, hawthorn extract, dietary nitrate, high-dose biotin, soy isoflavones, taurine, carnitine, magnesium orotate, EPA-rich fish oil, glycine, and copper. The potential advantages of whole-food plant-based diets, moderation in salt intake, avoidance of phosphate additives, and regular exercise training and sauna sessions are also discussed. There should be considerable scope for the development of functional foods and supplements which make it more convenient and affordable for patients to consume complementary combinations of the agents discussed here. Research Strategy: Key word searching of PubMed was employed to locate the research papers whose findings are cited in this essay. Full article
(This article belongs to the Special Issue Metabolic Therapies for Heart Failure)
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