Myocardial fatty acid metabolism in health and disease

Gary D. Lopaschuk, John R. Ussher, Clifford D.L. Folmes, Jagdip S. Jaswal, William C. Stanley

Research output: Contribution to journalReview article

997 Scopus citations

Abstract

There is a constant high demand for energy to sustain the continuous contractile activity of the heart, which is met primarily by the β-oxidation of long-chain fatty acids. The control of fatty acid β-oxidation is complex and is aimed at ensuring that the supply and oxidation of the fatty acids is sufficient to meet the energy demands of the heart. The metabolism of fatty acids via β-oxidation is not regulated in isolation; rather, it occurs in response to alterations in contractile work, the presence of competing substrates (i.e., glucose, lactate, ketones, amino acids), changes in hormonal milieu, and limitations in oxygen supply. Alterations in fatty acid metabolism can contribute to cardiac pathology. For instance, the excessive uptake and β-oxidation of fatty acids in obesity and diabetes can compromise cardiac function. Furthermore, alterations in fatty acid β-oxidation both during and after ischemia and in the failing heart can also contribute to cardiac pathology. This paper reviews the regulation of myocardial fatty acid β-oxidation and how alterations in fatty acid β-oxidation can contribute to heart disease. The implications of inhibiting fatty acid β-oxidation as a potential novel therapeutic approach for the treatment of various forms of heart disease are also discussed.

Original languageEnglish (US)
Pages (from-to)207-258
Number of pages52
JournalPhysiological Reviews
Volume90
Issue number1
DOIs
StatePublished - Jan 29 2010

ASJC Scopus subject areas

  • Physiology
  • Molecular Biology
  • Physiology (medical)

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    Lopaschuk, G. D., Ussher, J. R., Folmes, C. D. L., Jaswal, J. S., & Stanley, W. C. (2010). Myocardial fatty acid metabolism in health and disease. Physiological Reviews, 90(1), 207-258. https://doi.org/10.1152/physrev.00015.2009