title: Pyruvate dehydrogenase as a therapeutic target for obesity cardiomyopathy.
abstract: BACKGROUND
  Obesity cardiomyopathy is a major public health problem with few specific therapeutic options. Abnormal cardiac substrate metabolism with reduced pyruvate dehydrogenase (PDH) activity is associated with energetic and functional cardiac impairment and may be a therapeutic target.
  
  
  METHODS
  This review summarizes the changes to cardiac substrate and high energy phosphorus metabolism that occur in obesity and describes the links between abnormal metabolism and impairment of cardiac function. The available evidence for the currently available pharmacological options for selective metabolic therapy in obesity cardiomyopathy is reviewed.
  
  
  CONCLUSIONS
  Pharmacological restoration of PDH activity is in general associated with favourable effects upon cardiac substrate metabolism and function in both animal models and small scale human studies, supporting a potential role as a therapeutic target.
authors.affiliation: a Division of Cardiovascular Medicine, Radcliffe Department of Medicine , University of Oxford , Oxford , OX3 9DU , UK.|b Department of Physiology , Anatomy and Genetics, University of Oxford , Sherrington Road, Oxford , OX3 9DU , UK.
authors.forename: Andrew Jm
authors.initials: AJ
authors.lastname: Lewis
authors.affiliation: a Division of Cardiovascular Medicine, Radcliffe Department of Medicine , University of Oxford , Oxford , OX3 9DU , UK.
authors.forename: Stefan
authors.initials: S
authors.lastname: Neubauer
authors.affiliation: a Division of Cardiovascular Medicine, Radcliffe Department of Medicine , University of Oxford , Oxford , OX3 9DU , UK.|b Department of Physiology , Anatomy and Genetics, University of Oxford , Sherrington Road, Oxford , OX3 9DU , UK.
authors.forename: Damian J
authors.initials: DJ
authors.lastname: Tyler
authors.affiliation: a Division of Cardiovascular Medicine, Radcliffe Department of Medicine , University of Oxford , Oxford , OX3 9DU , UK.|b Department of Physiology , Anatomy and Genetics, University of Oxford , Sherrington Road, Oxford , OX3 9DU , UK.
authors.forename: Oliver J
authors.initials: OJ
authors.lastname: Rider
mesh_terms: D000818:Animals; D009202:Cardiomyopathies / Q000188:drug therapy* / Q000209:etiology; D004195:Disease Models, Animal; D004734:Energy Metabolism / Q000502:physiology; D006801:Humans; D058990:Molecular Targeted Therapy; D009765:Obesity / Q000150:complications / Q000188:drug therapy*; D010758:Phosphorus / Q000378:metabolism; D011768:Pyruvate Dehydrogenase Complex / Q000378:metabolism*
chemical_list: D011768:Pyruvate Dehydrogenase Complex; D010758:Phosphorus
keywords: Obesity; heart failure; imaging; metabolism