Lipids in the heart: a source of fuel and a source of toxins.
OBJECTIVE
How do lipids arrive in the heart and other tissues? This review focuses on new information on pathways of lipid uptake into the heart.


RESULTS
Fatty acids, the major cardiac fuel, are obtained from either lipoproteins or free fatty acids associated with albumin. The heart is the tissue with the most robust expression of lipoprotein lipase, and recent data attest to the importance of this enzyme in supplying optimal amounts of fatty acids for the heart. Genetic deletion of CD36 also shows that this transporter is important for cardiac uptake of lipids. Retinoid acquisition by the heart involves pathways parallel to those used for fatty acid uptake: a pathway for acquisition of core lipoprotein retinyl ester and another for nonlipoprotein retinol. Dilated lipotoxic cardiomyopathy is the consequence of excess lipid uptake.


CONCLUSIONS
Genetic modifications that affect lipid uptake, oxidation, and storage are being exploited to elucidate the pathophysiology of cardiomyopathies and to discover how lipids relate to heart failure in humans with obesity and diabetes mellitus. This information is likely to lead to new diagnostic categories of cardiomyopathy and more pathophysiologically appropriate treatments.
Park
Tae-Sik
TS
Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.
Yamashita
Haruyo
H
Blaner
William S
WS
Goldberg
Ira J
IJ
D000818:Animals; D018955:CD36 Antigens / Q000235:genetics / Q000502:physiology; D009202:Cardiomyopathies / Q000473:pathology; D005227:Fatty Acids / Q000378:metabolism; D005230:Fatty Acids, Nonesterified / Q000378:metabolism; D006321:Heart / Q000502:physiology; D006801:Humans; D050356:Lipid Metabolism; D008055:Lipids / Q000737:chemistry*; D008071:Lipoprotein Lipase / Q000378:metabolism; D008074:Lipoproteins / Q000378:metabolism; D008954:Models, Biological; D009206:Myocardium / Q000378:metabolism*; D047492:Peroxisome Proliferator-Activated Receptors / Q000378:metabolism
D018955:CD36 Antigens; D005227:Fatty Acids; D005230:Fatty Acids, Nonesterified; D008055:Lipids; D008074:Lipoproteins; D047492:Peroxisome Proliferator-Activated Receptors; D008071:Lipoprotein Lipase