从"气"探析心系疾病与线粒体功能障碍关系OA

Occurrence and progression of cardiovascular diseases were closely associated with myocardial ener-gy metabolism,redox homeostasis,calcium signaling regulation,and cell death.As core organelle involved in metabo-lism and energy conversion,mitochondrial dysfunction was involved throughout pathological processes of atheroscle-rosis,coronary heart disease,arrhythmia,and heart failure.Mitochondrial DNA abnormalities,impaired oxidative phosphorylation,excessive reactive oxygen species production,calcium homeostasis imbalance,and dysregulation of mitophagy and mitochondrial fission-fusion dynamics could jointly lead to structural and functional injury of cardio-myocytes and form a mutually reinforcing pathological cycle with disease progression.Qi was regarded as the basis of life activities and had functions of promotion,warming,defense,consolidation,and transformation.Its generation de-pends on innate essence,essence of water and grain,and natural clear Qi,while its movement was manifested as as-cending,descending,entering,and exiting,as well as the coordinated action of the Zangfu organs and meridians.Based on integrative understanding of Chinese and Western medicine,mitochondria and Qi share certain similarities in ori-gin,function,pathogenesis,and treatment.As an important hub of cellular homeostasis regulation,mitochondria may provide a microscopic explanation for the generation and movement of Qi and its role in nourishing the heart vessels.Mitochondrial dysfunction-induced myocardial energy deficiency,homeostatic disturbance,and cumulative injury can correspond to such pathological changes as heart Qi deficiency,Qi movement disorder,Qi deficiency and blood stasis,and dysfunction of Zangfu Qi transformation.Accordingly,Qi-based treatment of cardiovascular diseases should be established according to disease type,syndrome characteristics,and specific links of mitochondrial injury.Therapeutic strategies may include supplementing and regulating Zong Qi,balancing Yin and Yang Qi,harmonizing nutrient and defensive Qi,and integrally regulating Zangfu Qi.To improve mitochondrial biogenesis,energy metabolism,oxidative stress,mitochondrial membrane potential stability,and quality control.This theoretical framework may help elucidate the microscopic basis of syndrome differentiation and treatment of cardiovascular diseases in traditional Chinese med-icine and provide ideas for integrated Chinese and western medical intervention and subsequent mechanistic studies.