Highly active cardiomyocytes need iron for their metabolic activity. In physiological conditions, iron turnover is a delicate process which is dependent on global iron supply and local autonomous regulatory mechanisms. Though less is known about the autonomous regulatory mechanisms, data suggest that these mechanisms can preserve cellular iron turnover even in the presence of systemic iron disturbance. Therefore, activity of local iron protein machinery and its relationship with global iron metabolism is important to understand cardiac iron metabolism in physiological conditions and in cardiac disease. Our knowledge in this respect has helped in designing therapeutic strategies for different cardiac diseases. This review is a synthesis of our current knowledge concerning the regulation of cardiac iron metabolism. In addition, different models of cardiac iron dysmetabolism will be discussed through the examples of heart failure (cardiomyocyte iron deficiency), myocardial infarction (acute changes in cardiac iron turnover), doxorubicin-induced cardiotoxicity (cardiomyocyte iron overload in mitochondria), thalassaemia (cardiomyocyte cytosolic and mitochondrial iron overload) and Friedreich ataxia (asymmetric cytosolic/mitochondrial cardiac iron dysmetabolism). Finally, future perspectives will be discussed in order to resolve actual gaps in knowledge, which should be helpful in finding new treatment possibilities in different cardiac diseases.

中文翻译：

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通过铁代谢的平衡来保持心脏的动态平衡。

高度活跃的心肌细胞需要铁才能发挥其代谢活性。在生理条件下，铁的周转是一个微妙的过程，这取决于全球铁的供应和当地的自主监管机制。尽管对自主调节机制的了解较少，但数据表明，即使存在系统性铁紊乱，这些机制也可以保持细胞铁代谢。因此，局部铁蛋白机制的活动及其与整体铁代谢的关系对于了解生理状况和心脏病中的心脏铁代谢很重要。我们在这方面的知识有助于设计针对不同心脏病的治疗策略。这篇综述是我们目前有关调节心脏铁代谢的知识的综述。此外，将通过心力衰竭（心肌细胞铁缺乏症），心肌梗塞（心脏铁代谢的急性变化），阿霉素诱导的心脏毒性（线粒体中的心肌细胞铁超负荷），地中海贫血（心肌细胞胞质和线粒体）的实例讨论不同模型的心脏铁代谢异常铁超负荷）和弗里德赖希共济失调（不对称胞质/线粒体心脏铁代谢异常）。最后，将讨论未来的观点，以解决知识的实际差距，这将有助于在不同的心脏病中找到新的治疗方法。阿霉素引起的心脏毒性（线粒体中的心肌铁超载），地中海贫血（心肌细胞的胞质和线粒体铁超载）和弗里德里希共济失调（不对称的胞质/线粒体心脏铁代谢异常）。最后，将讨论未来的观点，以解决知识的实际差距，这将有助于在不同的心脏病中找到新的治疗方法。阿霉素引起的心脏毒性（线粒体中的心肌铁超载），地中海贫血（心肌细胞的胞质和线粒体铁超载）和弗里德里希共济失调（不对称的胞质/线粒体心脏铁代谢异常）。最后，将讨论未来的观点，以解决知识的实际差距，这将有助于在不同的心脏病中找到新的治疗方法。