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Mitochondrial energy metabolism in heart failure: a question of balance
Janice M. Huss, Daniel P. Kelly
Janice M. Huss, Daniel P. Kelly
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Mitochondrial energy metabolism in heart failure: a question of balance

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Abstract

The mitochondrion serves a critical role as a platform for energy transduction, signaling, and cell death pathways relevant to common diseases of the myocardium such as heart failure. This review focuses on the molecular regulatory events and downstream effector pathways involved in mitochondrial energy metabolic derangements known to occur during the development of heart failure.

Authors

Janice M. Huss, Daniel P. Kelly

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Figure 2

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PGC-1α is an integrator of the transcriptional network regulating mitoch...
PGC-1α is an integrator of the transcriptional network regulating mitochondrial biogenesis and function. Numerous signaling pathways, including Ca2+-dependent, NO, MAPK, and β-adrenergic pathways (β3/cAMP), activate the PGC-1α directly by increasing either PGC-1α expression or activity. Additionally, the p38MAPK pathway selectively activates PPARα, which may bring about synergistic activation in the presence of PGC-1α, whereas ERK-MAPK has the opposite effect. These signaling pathways transduce physiological stimuli, such as stress, fasting, and exercise, to the PGC-1α pathway. PGC-1α, in turn, coactivates transcriptional partners, including NRF-1 and -2, ERRα, and PPARα, which regulate mitochondrial biogenesis and FA-oxidation pathways. Dashed lines indicate activation mediated by signal transduction pathways in contrast to the coactivation by PGC-1α, which is denoted by solid lines. The arrows from ERRα to the NRFs and the PPAR complex indicate that ERRα activates these pathways at the level of expression.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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