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Metabolic Dysfunction in Heart Failure: Diagnostic, Prognostic, and Pathophysiologic Insights From Metabolomic Profiling

  • Biomarkers of Heart Failure (W H W Tang, Section Editor)
  • Published:
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Abstract

Metabolic impairment is an intrinsic component of heart failure (HF) pathophysiology. Although initially conceived as a myocardial defect, metabolic dysfunction is now recognized as a systemic process with complex interplay between the myocardium and peripheral tissues and organs. Specifically, HF-associated metabolic dysfunction includes alterations in substrate utilization, insulin resistance, defects in energy production, and imbalanced anabolic-catabolic signaling leading to cachexia. Each of these metabolic abnormalities is associated with significant morbidity and mortality in patients with HF; however, their detection and therapeutic management remains challenging. Given the difficulty in obtaining human cardiac tissue for research purposes, peripheral blood metabolomic profiling, a well-established approach for characterizing small-molecule metabolite intermediates from canonical biochemical pathways, may be a useful technology for dissecting biomarkers and mechanisms of metabolic impairment in HF. In this review, metabolic abnormalities in HF will be discussed with particular emphasis on the application of metabolomic profiling to detecting, risk stratifying, and identifying novel targets for metabolic therapy in this heterogeneous population.

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Acknowledgments

This review was supported in part by NIH grants TL1TR001116, T32HL7101-39, HL095987, as well as a postgraduate award from the Alpha Omega Alpha Honor Society.

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Authors and Affiliations

  1. Duke University School of Medicine, 300 North Duke Street, Durham, NC, 27701, USA

    Wynn G. Hunter & Svati H. Shah

  2. Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA

    Jacob P. Kelly, Robert W. McGarrah III, William E. Kraus & Svati H. Shah

  3. Duke Clinical Research Institute, Durham, NC, USA

    Jacob P. Kelly & Svati H. Shah

  4. Duke Molecular Physiology Institute, Durham, NC, USA

    Robert W. McGarrah III, William E. Kraus & Svati H. Shah

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  1. Wynn G. Hunter
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Correspondence to Svati H. Shah.

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Wynn G. Hunter, Jacob P. Kelly, William E. Kraus, Robert W. McGarrah, and Svati H. Shah declare that they have no conflict of interest.

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This article is part of the Topical Collection on Biomarkers of Heart Failure

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Hunter, W.G., Kelly, J.P., McGarrah, R.W. et al. Metabolic Dysfunction in Heart Failure: Diagnostic, Prognostic, and Pathophysiologic Insights From Metabolomic Profiling. Curr Heart Fail Rep 13, 119–131 (2016). https://doi.org/10.1007/s11897-016-0289-5

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