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- Englisch (2)
Schlagworte
- Barth syndrome (1)
- Calcium (1)
- Cardiolipin (1)
- Cardiomyopathy (1)
- MitoQ (1)
- Mitochondria (1)
- SGLT2 inhibitors (1)
- cardiac metabolism (1)
- elamipretide (1)
- heart failure (1)
In this Doctoral Thesis we investigated the consequences of perturbed mitochondrial calcium handling in the context of a rare human disease, Barth syndrome, in which the altered phospholipid composition of the inner mitochondrial membrane affects the structural organization of several protein complexes, including the mitochondrial calcium uniporter. We discovered that loss of the mitochondrial calcium uniporter in cardiac, but not skeletal muscle mitochondria hinders the calcium-induced adaptation of mitochondrial oxidative metabolism during workload transitions. This mechano-energetic uncoupling impairs the physiological increase in contractile force during physical exercise and might predispose Barth syndrome patients to the development of arrhythmias.
Purpose of Review
We review therapeutic approaches aimed at restoring function of the failing heart by targeting mitochondrial reactive oxygen species (ROS), ion handling, and substrate utilization for adenosine triphosphate (ATP) production.
Recent Findings
Mitochondria-targeted therapies have been tested in animal models of and humans with heart failure (HF). Cardiac benefits of sodium/glucose cotransporter 2 inhibitors might be partly explained by their effects on ion handling and metabolism of cardiac myocytes.
Summary
The large energy requirements of the heart are met by oxidative phosphorylation in mitochondria, which is tightly regulated by the turnover of ATP that fuels cardiac contraction and relaxation. In heart failure (HF), this mechano-energetic coupling is disrupted, leading to bioenergetic mismatch and production of ROS that drive the progression of cardiac dysfunction. Furthermore, HF is accompanied by changes in substrate uptake and oxidation that are considered detrimental for mitochondrial oxidative metabolism and negatively affect cardiac efficiency. Mitochondria lie at the crossroads of metabolic and energetic dysfunction in HF and represent ideal therapeutic targets.