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J Zhejiang Univ Sci B. 2013 Aug;14(8):688-95. doi: 10.1631/jzus.B1300137.

Metabolic remodeling in chronic heart failure.

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1
Department of Cardiology, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China.

Abstract

Although the management of chronic heart failure (CHF) has made enormous progress over the past decades, CHF is still a tremendous medical and societal burden. Metabolic remodeling might play a crucial role in the pathophysiology of CHF. The characteristics and mechanisms of metabolic remodeling remained unclear, and the main hypothesis might include the changes in the availability of metabolic substrate and the decline of metabolic capability. In the early phases of the disease, metabolism shifts toward carbohydrate utilization from fatty acids (FAs) oxidation. Along with the progress of the disease, the increasing level of the hyperadrenergic state and insulin resistance cause the changes that shift back to a greater FA uptake and oxidation. In addition, a growing body of experimental and clinical evidence suggests that the improvement in the metabolic capability is likely to be more significant than the selection of the substrate.

PMID:
23897787
PMCID:
PMC3735968
DOI:
10.1631/jzus.B1300137
[Indexed for MEDLINE]
Free PMC Article
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