Translation of Myocardial Metabolic Imaging Concepts into the Clinics

摘要

Flexibility in myocardial substrate metabolism for energy production is fundamental to cardiac health. This loss in plasticity or flexibility leads to an overdependence on the metabolism of an individual category of substrates, with the predominance in fatty acid metabolism characteristic of diabetic heart disease and the accelerated glucose use associated with pressure-overload left ventricular hypertrophy being prime examples. Important unresolved questions include the extent to which these metabolic patterns are adaptive and have the propensity to become maladaptive, what the key determinants of these metabolic perturbations are, do they alter prognosis, and do they represent robust targets for novel therapeutics. Accelerating our understanding of the role of alterations in myocardial substrate meta bolism in cardiac disease is the development of transgenic models targeting key aspects of myocardial substrate use. The relevance of the metabolic phenotype of these models to the corresponding human condition is frequently unclear, however. In addition, applied genomics have iden-