Heart failure is an enormous medical and societal burden.1,2It is a common disease: more than 2% of the U.S. population,or almost 5 million people, are affected, and 30 to 40% of patientsdie from heart failure within 1 year after receiving the diagnosis.3Heart failure can be disabling, and it can severely reduce apatient's quality of life. It consumes approximately 2% of theNational Health Service budget in the United Kingdom, and inthe United States, the total annual cost of treatment for heartfailure is approximately $28 billion. Moreover, the financialburden of heart failure will . . . [Full Text of this Article]
The Energy-Starvation Hypothesis
Cardiac Energy Metabolism
Components of Cardiac Energy Metabolism
The Creatine Kinase System
Assessment of Cardiac Energy Metabolism
Derangement of Energy Metabolism in Heart Failure
Substrate Utilization
Oxidative Phosphorylation
High-Energy Phosphate Metabolism
Molecular Regulators of Energy Metabolism
Nuclear-Receptor Transcription Factors
Gene-Knockout Models and Loss-of-Function Mutations
Implications for the Treatment of Heart Failure
Modulation of Substrate Utilization
Modulation of Oxidative Phosphorylation
Manipulation of High-Energy Phosphate Metabolites
Conclusions
Source Information
From the Department of Cardiovascular Medicine, University of Oxford and John Radcliffe Hospital, Oxford, United Kingdom.
Address reprint requests to Dr. Neubauer at the Department of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom, or at stefan.neubauer@cardiov.ox.ac.uk.
Related Letters:
The Failing Heart
Oh J., Chung J.-H., Kang S.-M., Smith S. W., Niederseer D., Thaler C., Niebauer J., Korantzopoulos P., Goudevenos J. A., Knaapen P., Knuuti J., van Rossum A. C., Taegtmeyer H., Haddy F. J., Neubauer S.
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N Engl J Med 2007;
356:2544-2546, Jun 14, 2007.
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(2007). The Failing Heart. NEJM
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[Full Text]
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