病理性心脏重塑的代谢变化与干预靶点

全球心血管疾病发病率和死亡率不断增加。病理性心脏重塑在心血管疾病发生发展中发挥重要作用。越来越多的研究关注在病理性心脏重塑中心脏代谢的改变。心脏肥大和心力衰竭时心脏代谢紊乱，心肌从脂肪酸为主的代谢特征转变为葡萄糖为主的代谢特征，心脏结构和功能发生异常。本文综述了病理性心脏重塑中脂肪酸、葡萄糖和氨基酸不同底物代谢变化特征及其对心脏功能的影响。基于病理性重塑的代谢改变分析潜在干预靶点，从代谢调节的角度为药物研发提供新路径和理论依据，以改善心脏肥大和心力衰竭患者的预后。

Metabolic alterations and therapeutic targets of pathological cardiac remodeling

The morbidity and mortality of cardiovascular diseases are increasing globally. Pathological cardiac remodeling plays an important role in the development of cardiovascular diseases. More and more investigations focus on the alterations of cardiac metabolism in pathological cardiac remodeling. Cardiac substrate metabolism is severely impaired during cardiac hypertrophy and heart failure, a shift from fatty acid metabolism to glucose metabolism, resulting in aggravated cardiac dysfunction. This review analyzes the relationship among the metabolism of different substrates in pathological cardiac remodeling. Based on these metabolic changes, we summarize the pharmacological agents, and raise new drug development strategies from the perspective of metabolic regulation, leading to an improved prognosis and treatment of patients with cardiac remodeling diseases.