Cardiac Metabolic Remodeling: Adaptive and Maladaptive Changes in Heart Failure

Abstract

Cardiac metabolic remodeling encompasses a spectrum of adaptive and maladaptive changes crucial in the pathophysiology of heart failure. Underlying this intricate process are multifaceted alterations in myocardial substrate utilization, mitochondrial function, and metabolic signaling pathways. In adaptive remodeling, the heart strives to maintain energy homeostasis through metabolic shifts aimed at preserving contractile function and cellular viability in the face of stressors such as pressure overload or ischemia. Conversely, maladaptive remodeling ensues when these compensatory mechanisms become overwhelmed, leading to metabolic inefficiencies, energetic deficits, and ultimately, progressive cardiac dysfunction. Understanding the dynamic interplay between metabolic adaptations and maladaptations is essential for developing targeted therapeutic strategies to mitigate the progression of heart failure and improve patient outcomes.