Relationship Between the Risk of Cardiovascular Disease and Mitochondrial Dysfunction
Source abstract
Abstract
Cardiovascular diseases (CVDs) remain a leading cause of death worldwide. Mitochondria, essential organelles within cells, play a crucial role in maintaining cardiovascular health by producing energy through ATP synthesis. The heart’s high energy demand makes it particularly sensitive to mitochondrial function. In CVDs, mitochondrial adaptability is compromised, resulting in dysfunction characterized by impaired respiratory chain activity, decreased ATP production, oxidative stress, and structural damage. This review consolidates current research on mitochondrial roles in CVD development, focusing on mitochondrial respiration, ATP synthesis, and the processes involved in maintaining mitochondrial quality, such as mitophagy. It discusses the challenges in developing therapies aimed at restoring mitochondrial function, including drug delivery issues and targeting specificity. The assessment includes analysis of mitochondrial anomalies associated with cardiac disease progression and potential therapeutic strategies. Mitochondrial dysfunction contributes to the progression of various CVDs by reducing energy output and increasing oxidative stress, leading to cardiomyocyte injury and death. Damaged mitochondria produce excessive reactive oxygen species (ROS), exacerbating cellular damage. Repairing mitochondrial components, especially the respiratory chain and ATP synthesis pathways, has shown potential in mitigating cellular injury and improving cardiac function. Restoring mitochondrial function is vital for preventing and treating CVDs. Targeted therapies that repair mitochondrial respiratory activity and enhance ATP production may reduce cellular damage, promote cardiomyocyte survival, and improve clinical outcomes. Understanding mitochondrial dynamics offers promising avenues for innovative interventions in cardiovascular health management.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Mitochondrial Function and Pathology · GDF15 and Related Biomarkers · Adipose Tissue and Metabolism
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
Institute of Bioimaging and Complex Biological Systems (IBSBC), National Research Council (CNR), Section of Catanzaro, 88100 Catanzaro, Italy
Institute for Biomedical Research and Innovation (IRIB), National Research Council (CNR), Mangone, 87050 Cosenza, Italy
Neurology Department, Pugliese-Ciaccio Hospital, 88100 Catanzaro, Italy
References (100+)
Show source-provided references
1. (2018). GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet, 392, 1736–1788.
2. World Health Organization (2026, January 08). Cardiovascular Diseases (CVDs). Available online: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds).
3. Epidemiology of cardiovascular disease in Europe10.1038/s41569-021-00607-3 ↗
4. Heart Disease and Stroke Statistics-2020 Update: A Report from the American Heart Association10.1161/CIR.0000000000000757 ↗
5. Global burden of cardiovascular diseases: Projections from 2025 to 2050
6. Epidemiology and the Magnitude of Coronary Artery Disease and Acute Coronary Syndrome: A Narrative Review10.2991/jegh.k.201217.001 ↗
7. Global burden of cardiovascular diseases and risk factors, 1990–2019: Update from the GBD 2019 study10.1016/j.jacc.2020.11.010 ↗
8. Varela-Chinchilla, C.D., Sánchez-Mejía, D.E., and Trinidad-Calderón, P.A. (2022). Congenital Heart Disease: The State-of-the-Art on Its Pharmacological Therapeutics. J. Cardiovasc. Dev. Dis., 9.10.3390/jcdd9070201 ↗
9. Myocardial infarction in adults with congenital heart disease10.1016/j.amjcard.2017.08.050 ↗
10. Long-term outcomes after myocardial infarction in middle-aged and older patients with congenital heart disease: A nationwide study
11. Ischemic stroke in adults with congenital heart disease: A population-based cohort study10.1161/JAHA.118.011870 ↗
12. Stroke in adults with congenital heart disease: Incidence, cumulative risk, and predictors10.1161/CIRCULATIONAHA.115.011241 ↗
13. Mitochondrial oxidative phosphorylation defect in the heart of subjects with coronary artery disease10.1038/s41598-019-43761-y ↗
14. Oxidative stress, mitochondrial damage and neurodegenerative diseases
15. Cardiac energy metabolism in heart failure10.1161/CIRCRESAHA.121.318241 ↗
16. Mitochondrial injury and dysfunction in hypertension-induced cardiac damage10.1093/eurheartj/ehu436 ↗
17. Mitochondrial dysfunction in cardiovascular disease: Current status of translational research/clinical and therapeutic implications10.1002/med.21732 ↗
18. Kaludercic, N., and Di Lisa, F. (2020). Mitochondrial ROS formation in the pathogenesis of diabetic cardiomyopathy. Front. Cardiovasc. Med., 7.10.3389/fcvm.2020.00012 ↗
19. Ischaemic accumulation of succinate controls reperfusion injury through mitochondrial ROS10.1038/nature13909 ↗
20. Mitochondrial function as a therapeutic target in heart failure10.1038/nrcardio.2016.203 ↗
21. Mitochondrial dysfunction in pathophysiology of heart failure10.1172/JCI120849 ↗
22. Circulating mitochondrial DAMPs cause inflammatory responses to injury10.1038/nature08780 ↗
23. Cardioprotective effects of a novel mitochondrial-targeted antioxidant in myocardial ischemia-reperfusion injury
24. Mitochondria-targeted peptide antioxidants: Novel neuroprotective agents
25. Mitochondria and cardiovascular aging
26. Dabravolski, S.A., Khotina, V.A., Sukhorukov, V.N., Kalmykov, V.A., Mikhaleva, L.M., and Orekhov, A.N. (2021). The Role of Mitochondrial DNA Mutations in Cardiovascular Diseases. Int. J. Mol. Sci., 23.10.3390/ijms23020952 ↗
27. Mechanisms of mitophagy in cellular homeostasis, physiology and pathology10.1038/s41556-018-0176-2 ↗
28. Mitochondrial dysfunction and oxidative stress in heart disease10.1038/s12276-019-0355-7 ↗
29. Cardiovascular health and mitochondrial function: Testing an association10.1093/gerona/glaa297 ↗
30. The process of mammalian mitochondrial protein synthesis10.1007/s00441-016-2456-0 ↗
31. Structure of mammalian respiratory complex I10.1038/nature19095 ↗
32. Association between mitochondrial DNA copy number and sudden cardiac death: Findings from the ARIC study10.1093/eurheartj/ehx354 ↗
33. A two-way street: Reciprocal regulation of metabolism and signalling10.1038/nrm3305 ↗
34. Mitochondrial DNA damage is more extensive and persists longer than nuclear DNA damage in human cells following oxidative stress10.1073/pnas.94.2.514 ↗
35. Sequence and organization of the human mitochondrial genome10.1038/290457a0 ↗
36. Mitochondria in oxidative stress, inflammation and aging: From mechanisms to therapeutic advances10.1038/s41392-025-02253-4 ↗
37. Nuclear and mitochondrial genetic variants associated with mitochondrial DNA copy number10.1038/s41598-024-52373-0 ↗
38. Mitochondrial DNA copy number and risk of cardiovascular disease and all-cause mortality: A systematic review and meta-analysis of observational studies10.1093/qjmed/hcae208 ↗
39. Dynamics of mitochondrial DNA nucleoids regulated by mitochondrial fission is essential for maintenance of homogeneously active mitochondria during neonatal heart development10.1128/MCB.01054-14 ↗
40. Mitochondrial dynamics in health and disease10.1002/1873-3468.14077 ↗
41. Mitochondrial dynamics and apoptosis10.1101/gad.1658508 ↗
42. Mitochondrial fission, fusion, and stress10.1126/science.1219855 ↗
43. Mitochondrial dynamics: Overview of molecular mechanisms10.1042/EBC20170104 ↗
44. Mitophagy-related regulated cell death: Molecular mechanisms and disease implications10.1038/s41419-024-06804-5 ↗
45. The role of mitochondrial transport in energy metabolism10.1016/S1567-7249(03)00008-4 ↗
46. Fusion and fission: Interlinked processes critical for mitochondrial health10.1146/annurev-genet-110410-132529 ↗
47. Cyclic AMP-dependent protein kinase phosphorylation of Drp1 regulates its GTPase activity and mitochondrial morphology10.1074/jbc.C700083200 ↗
48. Dephosphorylation by calcineurin regulates translocation of Drp1 to mitochondria10.1073/pnas.0808249105 ↗
49. Erk2 phosphorylation of Drp1 promotes mitochondrial fission and MAPK-driven tumor growth10.1016/j.molcel.2015.01.002 ↗
50. Reversible phosphorylation of Drp1 by cyclic AMP-dependent protein kinase and calcineurin regulates mitochondrial fission and cell death10.1038/sj.embor.7401062 ↗
51. Mitofusins Mfn1 and Mfn2 coordinate mitochondrial fusion and are essential for embryonic development10.1083/jcb.200211046 ↗
52. Disruption of fusion results in mitochondrial heterogeneity and dysfunction10.1074/jbc.M503062200 ↗
53. Mitochondrial fusion is required for mtDNA stability in skeletal muscle and tolerance of mtDNA mutations10.1016/j.cell.2010.02.026 ↗
54. Molecular mechanisms and physiological functions of mitophagy10.15252/embj.2020104705 ↗
55. Rheb regulates mitophagy induced by mitochondrial energetic status10.1016/j.cmet.2013.03.014 ↗
56. Mitochondrial dynamics: Shaping and remodeling an organelle network10.1016/j.ceb.2020.08.014 ↗
57. Ultrastructure and dynamics of the actin-myosin II cytoskeleton during mitochondrial fission10.1038/s41556-019-0313-6 ↗
58. How cytoskeletal proteins regulate mitochondrial energetics in cell physiology and diseases10.1098/rstb.2021.0324 ↗
59. In-cell structures of conserved supramolecular protein arrays at the mitochondria-cytoskeleton interface in mammalian sperm10.1073/pnas.2110996118 ↗
60. Kuznetsov, A.V., Javadov, S., Grimm, M., Margreiter, R., Ausserlechner, M.J., and Hagenbuchner, J. (2020). Crosstalk between mitochondria and cytoskeleton in cardiac cells. Cells, 9.10.3390/cells9010222 ↗
61. Brillo, V., Chieregato, L., Leanza, L., Muccioli, S., and Costa, R. (2021). Mitochondrial Dynamics, ROS, and Cell Signaling: A Blended Overview. Life, 11.10.3390/life11040332 ↗
62. Mitochondrial DNA: Impacting central and peripheral nervous systems10.1016/j.neuron.2014.11.022 ↗
63. The axonal transport of mitochondria
64. Doxorubicin alters the mitochondrial dynamics machinery and mitophagy in the liver of treated animals10.1111/fcp.12073 ↗
65. Bakula, D., and Scheibye-Knudsen, M. (2020). MitophAging: Mitophagy in aging and disease. Front. Cell Dev. Biol., 8.10.3389/fcell.2020.00239 ↗
66. Abrogating Mitochondrial Dynamics in Mouse Hearts Accelerates Mitochondrial Senescence10.1016/j.cmet.2017.09.023 ↗
67. Mitofusin 2 ablation increases endoplasmic reticulum-mitochondria coupling10.1073/pnas.1504880112 ↗
68. Patil, R., Wang, H., Kazaleh, M., Ailawadi, G., and Salmon, M. (2025). Dysregulation of Mitochondrial Homeostasis in Cardiovascular Diseases. Pharmaceuticals, 18.10.3390/ph18010112 ↗
69. Mitophagy-regulated mitochondrial health strongly protects the heart against cardiac dysfunction after acute myocardial infarction10.1111/jcmm.17190 ↗
70. Endogenous Drp1 mediates mitochondrial autophagy and protects the heart against energy stress10.1161/CIRCRESAHA.116.303356 ↗
71. Drp1/Fis1 interaction mediates mitochondrial dysfunction in septic cardiomyopathy10.1016/j.yjmcc.2019.04.006 ↗
72. Metabolic control of autophagy10.1016/j.cell.2014.11.006 ↗
73. Autophagy in Cardiovascular Aging10.1161/CIRCRESAHA.118.312208 ↗
74. Mitochondrial cytopathies and cardiovascular disease10.1136/heartjnl-2013-304657 ↗
75. Dubois-Deruy, E., Peugnet, V., Turkieh, A., and Pinet, F. (2020). Oxidative stress in cardiovascular diseases. Antioxidants, 9.10.3390/antiox9090864 ↗
76. Hahn, A., and Zuryn, S. (2019). Mitochondrial Genome (mtDNA) Mutations that Generate Reactive Oxygen Species. Antioxidants, 8.10.3390/antiox8090392 ↗
77. Animal models of atherosclerosis10.1016/j.ejphar.2017.05.010 ↗
78. Cardiac mitochondria and reactive oxygen species generation10.1161/CIRCRESAHA.114.300559 ↗
79. Al-Awar, A., and Hussain, S. (2024). Interplay of Reactive Oxygen Species (ROS) and Epigenetic Remodelling in Cardiovascular Diseases Pathogenesis: A Contemporary Perspective. Front. Biosci., 29.10.31083/j.fbl2911398 ↗
80. Advances in myocardial energy metabolism: Metabolic remodelling in heart failure and beyond10.1093/cvr/cvae231 ↗
81. Myung, S.K., Kim, H.B., Lee, Y.J., Choi, Y.J., and Oh, S.W. (2021). Calcium Supplements and Risk of Cardiovascular Disease: A Meta-Analysis of Clinical Trials. Nutrients, 13.10.3390/nu13020368 ↗
82. Liao, X., Han, Y., He, Y., Liu, J., and Wang, Y. (2023). Natural compounds targeting mitochondrial dysfunction: Emerging therapeutics for target organ damage in hypertension. Front. Pharmacol., 14.10.3389/fphar.2023.1209890 ↗
83. Regulation of cell death in the cardiovascular system10.1016/bs.ircmb.2019.11.005 ↗
84. Elevated markers of death receptor-activated apoptosis are associated with increased risk for development of diabetes and cardiovascular disease10.1016/j.ebiom.2017.11.023 ↗
85. Programmed death of cardiomyocytes in cardiovascular disease and new therapeutic approaches10.1016/j.phrs.2024.107281 ↗
86. Current Advances of Mitochondrial Dysfunction and Cardiovascular Disease and Promising Therapeutic Strategies10.1016/j.ajpath.2023.06.013 ↗
87. Yang, H.M. (2025). Mitochondrial Dysfunction in Cardiovascular Diseases. Int. J. Mol. Sci., 26.10.3390/ijms26051917 ↗
88. Recent insights into the cellular biology of atherosclerosis
89. Mitochondrial DNA damage and atherosclerosis
90. Mechanisms of plaque formation and rupture
91. Vitamin E: Non-antioxidant roles10.1016/S0163-7827(00)00006-0 ↗
92. Mitochondrion as a selective target for treatment of atherosclerosis: Role of mitochondrial DNA mutations and defective mitophagy in the pathogenesis of atherosclerosis and chronic inflammation10.2174/1570159X17666191118125018 ↗
93. Metabolic remodelling in heart failure10.1038/s41569-018-0044-6 ↗
94. Attenuation of angiotensin II-induced vascular dysfunction and hypertension by overexpression of thioredoxin 210.1161/HYPERTENSIONAHA.108.127928 ↗
95. Endothelial dysfunction in cardiovascular diseases: The role of oxidant stress10.1161/01.RES.87.10.840 ↗
96. Effect of vitamin C on endothelial function in health and disease: A systematic review and meta-analysis of randomized controlled trials
97. Ischemia/reperfusion injury and cardioprotective mechanisms: Role of mitochondria and reactive oxygen species10.4330/wjc.v3.i6.186 ↗
98. The mitochondrial permeability transition pore and its role in myocardial ischemia reperfusion injury
99. Ischemic preconditioning alters real-time measure of myocardial ROS generation in the ischemic and reperfused heart
100. Mitochondrial pathways, permeability transition pore, and redox signaling in cardioprotection: Therapeutic implications10.1089/ars.2011.4459 ↗