Myocardial fatty acid metabolic pathway

The "myocardial fatty acid metabolic pathway" refers to the collection of coordinated biochemical processes within the heart muscle (myocardium) that govern the uptake, transport, and oxidation of fatty acids for ATP production. In healthy adult hearts, approximately 60–90% of the required energy is produced through mitochondrial β-oxidation of long-chain fatty acids, with key regulatory roles played by transporters such as CD36 and enzymes such as carnitine palmitoyltransferase-1 (CPT1) and various β-oxidation enzymes. These processes are tightly regulated at molecular and transcriptional levels (e.g., by PPAR-α and PGC-1α) and are altered in various disease states including heart failure and ischemia, where shifts toward increased glucose or ketone utilization or impaired fatty acid handling can occur. Multiple drugs target these pathways by modulating key steps in fatty acid uptake or oxidation, aiming to protect against ischemic injury or improve cardiac efficiency. However, the pathway is not a single molecular target but a network; thus, "myocardial fatty acid metabolic pathway" is not a canonical therapeutic target but describes a set of metabolic processes implicated in cardiac physiology and disease[3][5][8][2][4][1][6].

Other names

Fatty acid oxidation in heartCardiac fatty acid metabolismMyocardial FAOCardiac lipid metabolism

- Inhibition or modulation of key enzymes (e.g., CPT1, 3-ketoacyl-CoA thiolase) in fatty acid β-oxidation - Modulation of fatty acid uptake transporters (e.g., CD36 inhibitors) - Shift of myocardial substrate utilization from fatty acids to glucose or ketone bodies