Heart Failure Association. Mitochondria and Metabolism Targets for the Treatment of Heart Failure

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Heart Failure Association HFA Translational Research Workshop 2012 of the European Society of Cardiology Translational Research Workshop 2012 Mitochondria and Metabolism Targets for the Treatment of Heart Failure Palace of Academies, Brussels, BE May 3-4, 2012 Ca 2 Fe 3 Ca 2

Thursday, May 3 rd, 2012 12:00 13:15 Arrival and lunch at Royal Palace of Academies, Brussels 13:15 13:30 Welcome (Stefan Janssens, Christoph Maack) Session 1: Substrate utilization in heart failure: Compensation or maladaptation? Perhexilline Ranolazine Ca 2 Fe 3 Ca 2 The normal heart utilizes ~70% fatty acids and ~30% glucose. In heart failure, various changes of substrate utilization occur, dependent on the severity of the syndrome, but also on the species investigated. It is currently controversial whether the changes in substrate metabolism are maladaptive or an adaptive compensation. This session is aimed at if possible reaching a consensus on the most important and consistent changes in substrate utilization of the failing heart, and whether they are adaptive or maladaptive. Furthermore, possible treatment options with a focus on clinical results will be discussed. Gerd Hasenfuss (Göttingen, DE) Wolfram Doehner (Berlin, DE) Talks: 10 min, Discussion: 15 min 13:30 13:55 Juhani Knuuti (Turku, FI) Substrate utilization and the metabolic switch in heart failure adaptation or maladaptaion? 13:55 14:20 Heiko Bugger (Freiburg, DE) Metabolic changes in diabetic cardiomyopathy role of free fatty acids 14:20 14:45 Renée Ventura-Clapier (Châtenay-Malabry, FR) Which drugs improve impaired mitochondrial biogenesis in heart failure, and why? 14:45 15:10 William Stanley (Baltimore, US) Food supplementation with polyunsaturated fatty acids in CHF animal models and clinical trials 15:10 15:35 Michael Frenneaux (Aberdeen, UK) Inhibiting fatty acid oxidation in patients with chronic heart failure: Clinical results with perhexilline 15:35 16:00 Coffee break

Session 2: Metabolic interventions in heart failure: Which treatment options do we have? Burkert M. Pieske (Graz, AT) Thomas Eschenhagen (Hamburg, DE) 16:00 16:25 Juhani Knuuti (Turku, FI) Clinical results with trimetazidine 16:25 16:50 Lars S. Maier (Göttingen, DE) Ranolazine metabolic intervention, ion channel blockade, or both? 16:50 17:15 Ewa Jankowska (Wroclaw, PL) Clinical results with iron supplementation in heart failure 17:15 17:40 Hossein Ardehali (Chicago, US) Role of iron for mitochondrial function in the heart 17:40 19:00 General discussion 20:00 Dinner

Friday, May 4 th, 2012 Session 3: Mechanisms of oxidative stress in heart failure and treatment options Ca 2 Fe 3 Ca 2 Oxidative stress plays a causal role in the progression of heart failure and yet, no antioxidant treatment was successful in patients with cardiovascular diseases. The sources of oxidative stress in the failing heart are manifold, but include mitochondria and NADPH oxidases. The regulation of the production of reactive oxygen species () in mitochondria is complex and involves dynamic variations in pro- and antioxidative processes. Recently, crosstalk between NADPH oxidases and mitochondria and the phenomenon of -induced release from mitochondria has been put forward. Controversial results have been obtained as to the role of the NADPH oxidase subtype Nox4, which is unequivocally upregulated in heart failure, but whose role (protective or maladaptive) and location (mitochondria, ER) is not fully resolved. This session aims at understanding the basic concepts of mitochondrial and NADPH-oxidase dependent production, its dynamic fine-tuning in a working heart and pathophysiological changes in the failing heart. Furthermore, therapeutic concepts with special emphasis on clinical results will be discussed. Discussants Rainer Schulz (Giessen, DE) Andrew Halestrap (Bristol, UK) 08:00 08:25 Brian O Rourke (Baltimore, US) Mechanisms of mitochondrial production and the concept of Redox-optimized balance 08:25 08:50 Alexander Nickel (Homburg, DE) How increased workload provokes mitochondrial production 08:50 09:15 Fabio Di Lisa (Padova, IT) MAO and p66 as sources of mitochondrial in heart failure 09:15 09:40 Ajay Shah (London, UK) -mediated protective effects in heart failure 09:40 10:05 Peter S. Rabinovitch (St. Louis, US) The importance of targeting mitochondrial oxidative stress in heart failure 10:05 10:30 General Discussion 10:30 11:00 Coffee break

Session 4: Novel techniques for the analysis of cardiac metabolism: Interface to industry This session is aimed at introducing state of the art in particular, novel techniques to monitor parameters of mitochondrial energetics and cardiac function and how to dissect signalling pathways involved in metabolic remodelling. The session also represents an interface between science and industry and may catalyze fruitful interaction between basic and clinical scientists and the industry. Ludwig Neyses (Manchester, UK) Zoltan Papp (Debrecen, HU) 11:00 11:30 Manuel Mayr (London, UK) Combining transcriptomic, proteomic and metabolomic analyses to approach metabolic remodelling in heart failure 11:30 12:00 Stuart Cook (London, UK) Integrative genomics to identify mechanism of metabolic dysfunction in heart failure 12:00 12:30 Kieran Clarke (Oxford, UK) Clinical Cardiac Magnetic Resonance Spectroscopy 12:30 13:10 General Discussion 13:10 Closing remarks (Christoph Maack) 13:20 Lunch, departure