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Metabolism’s Surprising Importance in Cardiology

When you hear the word “metabolism,” the first thing that comes to mind is probably weight. You’ve likely heard people talk about having a slow metabolism or a fast metabolism, in reference to how quickly their bodies process food and burn calories. But did you know that metabolism plays an important role in heart health?

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Adenosine triphosphate (ATP) molecule, which transports energy within cells for metabolism

Metabolism is a cornerstone for everyday human physiology—it’s involved in every chemical process in your body. Metabolism is at work in two significant ways: using molecules to create energy and using energy to build cells, tissue and organs.

The cardiovascular system, which includes the heart, blood vessels and blood, is responsible for circulating nutrients throughout the body. In this way, the bloodstream both delivers energy and removes waste resulting from the metabolic process in cells.

So, if a person’s metabolism goes awry, problems can manifest in some very serious ways. For example, when heart cells are deprived of the molecules they need to grow, they become energy starved and are forced to compensate, often resulting in cardiovascular disease.

The field of metabolic cardiology is focused on the prevention, management and treatment of cardiovascular disease at the cellular level. Zolt Arany, MD, PhD, a new associate professor of Medicine at the Perelman School of Medicine, is a physician-scientist whose research focuses in part on the genes responsible for cell metabolism within the heart.

“There has been quite a bit of research on metabolism in cancer cells, but the role of metabolism in vascular cell biology isn’t as well known,” said Arany. “I’m particularly interested in identifying genes that help regulate vascular metabolism, so we can use that information to prevent and treat cardiovascular disease.”

For example, the Arany lab is trying to understand how fat is shuttled along blood vessels, and how that contributes to both diabetes and heart disease. In previous studies, Arany has found that a molecule called PGC-1 alpha responds very differently to low levels of oxygen and nutrients in muscle cells versus blood vessel cells—which is significant because it shows the potential harm of an otherwise-considered “good” molecule in the case of vasculature.

Similar to many areas of medical research, metabolic cardiology is an example of a multidisciplinary approach to disease management that can eventually be translated to patient care. “It’s a marathon run at a sprinter’s pace,” said Arany. “There’s so much we want to learn about cell metabolism within the cardiovascular system and so many applications for this work. It’s definitely a labor of love—after all, we are talking about the heart.”

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