The neurometabolic axis: A novel therapeutic target in heart failure

Abnormal cardiac metabolism or cardiac metabolic remodeling is reported before the onset of heart failure with reduced ejection fraction (HFrEF) and is known to trigger and maintain the mechanical dysfunction and electrical, and structural abnormalities of the ventricle. A dysregulated cardiac auton...

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Bibliographic Details
Published in:Life sciences (1973) 2023-11, Vol.333, p.122122-122122, Article 122122
Main Authors: Chakraborty, Praloy, Po, Sunny S., Scherlag, Benjamin J., Dasari, Tarun W.
Format: Article
Language:English
Subjects:
Adrenergic system
Autonomic nervous system
Cholinergic system
Heart failure
Metabolic remodeling
Neuromodulation
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Summary:Abnormal cardiac metabolism or cardiac metabolic remodeling is reported before the onset of heart failure with reduced ejection fraction (HFrEF) and is known to trigger and maintain the mechanical dysfunction and electrical, and structural abnormalities of the ventricle. A dysregulated cardiac autonomic tone characterized by sympathetic overdrive with blunted parasympathetic activation is another pathophysiological hallmark of HF. Emerging evidence suggests a link between autonomic nervous system activity and cardiac metabolism. Chronic β-adrenergic activation promotes maladaptive metabolic remodeling whereas cholinergic activation attenuates the metabolic aberrations through favorable modulation of key metabolic regulatory molecules. Restoration of sympathovagal balance by neuromodulation strategies is emerging as a novel nonpharmacological treatment strategy in HF. The current review attempts to evaluate the ‘neuro-metabolic axis’ in HFrEF and whether neuromodulation can mitigate the adverse metabolic remodeling in HFrEF. [Display omitted]
ISSN:0024-3205
1879-0631
DOI:10.1016/j.lfs.2023.122122