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Martínez et al. Vessel Plus 2017;1:230-41 Vessel Plus
DOI: 10.20517/2574-1209.2017.34
www.vpjournal.net
Review Open Access

Energetic metabolism in cardiomyocytes:

molecular basis of heart ischemia and

arrhythmogenesis

María Sofía Martínez , Andrés García , Eliana Luzardo , Mervin Chávez-Castillo , Luis Carlos Olivar , Juan Salazar ,
1
1
1
1
1
1
Manuel Velasco , Joselyn Joanna Rojas Quintero , Valmore Bermúdez 1,4
2
1,3
1 Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, 4001 Maracaibo, Venezuela.
2 Department of Pharmacology, “JM Vargas” Medical School, Central University of Venezuela, 1051 Caracas, Venezuela.
3 Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA.
4 Advanced Frontier Studies Research Group (ALEF), Simón Bolívar University, 54003 Cúcuta, Colombia.
Correspondence to: Dr. María Sofía Martinez, Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, 4001
Maracaibo, Venezuela. E-mail: mmartinez@fmed.luz.edu.ve
How to cite this article: Martínez MS, García A, Luzardo E, Chávez-Castillo M, Olivar LC, Salazar J, Velasco M, Rojas Quintero JJ, Bermúdez V.
Energetic metabolism in cardiomyocytes: molecular basis of heart ischemia and arrhythmogenesis. Vessel Plus 2017;1:230-41.
ABSTRACT
Article history: Cardiac muscle contraction is a strictly regulated process which conjugates a series of
Received: 19 Oct 2017 electrophysiological, biochemical and mechanic events, resulting in the pumping of blood to
First Decision: 15 Nov 2017 all bodily tissues. These phenomena require a very high energetic demand both for generating
Revised: 29 Nov 2017 the necessary mechanical force, and for maintaining cellular homeostasis during the process.
Accepted: 29 Nov 2017 In the myocardium, fatty acids (FA) represent the main energy substrate, although other
Published: 28 Dec 2017 secondary substrates, such as glucose and ketone bodies, may also be used. Nevertheless,
under certain conditions such as heart failure or myocardial ischemia, FA metabolism may
Keywords: become deleterious via mechanisms such as oxidative stress and arrhythmogenesis. In an
Myocardial metabolism, ischemic milieu, various metabolic changes occur as a consequence of hypoxia, favoring cell
cardiomyocyte, necrosis, ventricular arrhythmias, and death. Major events in this context include an increase
myocardial infarction, in extracellular K , a decrease in pH, and accumulation of intracellular calcium. This review
+
ischemia,
arrhythmias includes a detailed description of the molecular basis underlying myocardial contraction and
energetic metabolism in cardiomyocytes, aiming to promote an integral understanding of the
pathophysiology of heart ischemia. This in turn may aid in the development of future, more
satisfactory alternative treatments in the management of acute coronary ischemia episodes.

INTRODUCTION (ATP) production. However, in cardiomyocytes, the
majority of the energy produced derives from the
[1]
The heart is composed of specialized muscle tissue, mitochondrial oxidation of free fatty acids (FA) .
the myocardium, which depends on a constant input
of energy for adequate functioning, and thus utilizes Alterations in myocardial energetic metabolism may
various sources of carbon for adenosine triphosphate lead to conditions such as ischemic heart disease,

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