代谢在生理性和病理性心室重构的研究进展

Research progress in metabolism in physiological and pathological ventricular remodeling

代谢途径支持组织稳态和促进细胞表型改变,尤其是在消耗能量最大的心脏,底物不仅可以再生ATP用于心肌收缩,还可以维持细胞结构的生物合成反应。代谢途径也控制细胞内氧化还原状态,同时代谢中间产物和终产物可促进酶活性和基因表达的变化。越来越多的证据表明,在运动、妊娠、发育期间以及病理性应激中发生心脏代谢的变化是心室重构的原因。本文综述整合了不同形式心室重构的知识,以葡萄糖分解与合成代谢间的关系为基础,进一步阐述代谢如何调节心脏结构和功能。

The metabolic pathways support tissue homeostasis and promote cell phenotypic changes,especially in organs where the heart consumes the most energy.The substrate not only regenerates ATP for myocardial contraction,but also maintains the biosynthesis of cellular structures.Metabolic pathways also control intracellular redox states,metabolic intermediates,and end products,providing signals that promote changes in enzyme activity and gene expression.There is increasing evidence that changes in cardiac metabolism during exercise,pregnancy,developing and pathological stress are among the causes of ventricular remodeling.Disorders of catabolism and anabolism are becoming major causes of pathological ventricular remodeling.This review integrates knowledge of different forms of ventricular remodeling,based on the relationship between glucose breakdown and anabolism,and further illustrates how metabolism regulates cardiac structure and function.