Why the study?
Disrupted bioenergetic homeostasis has increasingly been recognized as a key feature of HCM pathophysiology, motivating a critical evaluation of cardiometabolic alterations.
This review highlights the role of disrupted bioenergetic homeostasis in hypertrophic cardiomyopathy and the potential for targeting metabolic pathways therapeutically.
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Metabolic pathway targeting in HCM merits prospective trials; leaves open whether such interventions alter clinical outcomes.
Hypertrophic cardiomyopathy (HCM) is a highly common cardiomyopathy and is characterized by left ventricular hypertrophy and diastolic dysfunction. In half of the cases, HCM is associated with mutations in genes encoding sarcomere proteins, while the remaining cases occur without identifiable genetic mutations. Disrupted bioenergetic homeostasis has increasingly been recognized as a key feature of HCM pathophysiology. In this review, we summarize and critically evaluate studies addressing cardiometabolic alterations in HCM, with a particular focus on human-based research. These include non-invasive imaging studies, blood-based analyses, and molecular and functional assays of myocardial tissue. We also explore the therapeutic potential of targeting metabolic pathways in HCM and highlight promising directions for future studies.
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Nollet et al. (2025) studied this question.
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