Linking gene expression to function: metabolic flexibility in the normal and diseased heart

Ann N Y Acad Sci. 2004 May;1015:202-13. doi: 10.1196/annals.1302.017.


Metabolism transfers energy from substrates to ATP. As a "metabolic omnivore," the normal heart adapts to changes in the environment by switching from one substrate to another. We propose that this flexibility is lost in the maladapted, diseased heart. Both adaptation and maladaptation are the results of metabolic signals that regulate transcription of key cardiac regulatory genes. We propose that metabolic remodeling precedes, initiates, and sustains functional and structural remodeling. The process of metabolic remodeling then becomes a target for pharmacological intervention restoring metabolic flexibility and normal contractile function of the heart.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Diabetes Mellitus / metabolism
  • Diabetes Mellitus / physiopathology
  • Gene Expression*
  • Humans
  • Myocardium / metabolism*
  • Receptors, Cytoplasmic and Nuclear / metabolism
  • Transcription Factors / metabolism


  • Receptors, Cytoplasmic and Nuclear
  • Transcription Factors