Peroxisome Proliferator-Activated Receptors (PPAR): A Potential Strategy to Combat Lipotoxic Heart Disease

Obesity has been increasing dramatically in developed countries, which portends a higher incidence of cardiovascular risk factors such as insulin resistance, type 2 diabetes and hypertension. Accumulating evidence shows that the occurrence of heart disease in obesity is associated with the systemic dysregulation of lipid metabolism and not necessarily with hypertension and coronary artery disease. The impaired lipid metabolism may lead to cardiac lipid accumulation or "lipotoxic heart disease."1 This is also encountered in diabetic cardiomyopathy and in late stages of heart failure when global cardiac energy production is impaired. The accumulation of excess lipids has been known to cause cell dysfunction and/or cell death in non-adipose tissues such as the pancreas, although it is unknown whether a direct link between lipid accumulation and cell death occurs in the heart. Nevertheless, prevention or antagonism of cardiac lipid accumulation may serve as an adjunctive therapy for a variety of heart disorders that are accompanied by metabolic derangement.