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Review

Duality of Branched-Chain Amino Acids in Chronic Cardiovascular Disease: Potential Biomarkers versus Active Pathophysiological Promoters

by
Daniela Maria Tanase
1,2,†,
Emilia Valasciuc
1,2,*,
Claudia Florida Costea
3,4,†,
Dragos Viorel Scripcariu
5,6,
Anca Ouatu
1,2,
Loredana Liliana Hurjui
7,8,
Claudia Cristina Tarniceriu
9,10,
Diana Elena Floria
1,11,
Manuela Ciocoiu
12,
Livia Genoveva Baroi
13,14 and
Mariana Floria
1,2
1
Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
2
Internal Medicine Clinic, “St. Spiridon” County Clinical Emergency Hospital, Iasi 700111, Romania
3
Department of Ophthalmology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
4
2nd Ophthalmology Clinic, “Prof. Dr. Nicolae Oblu” Emergency Clinical Hospital, 700309 Iași, Romania
5
Department of General Surgery, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
6
Regional Institute of Oncology, 700483 Iasi, Romania
7
Department of Morpho-Functional Sciences II, Physiology Discipline, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
8
Hematology Laboratory, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iasi, Romania
9
Department of Morpho-Functional Sciences I, Discipline of Anatomy, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
10
Hematology Clinic, “Sf. Spiridon” County Clinical Emergency Hospital, 700111 Iasi, Romania
11
Institute of Gastroenterology and Hepatology, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iasi, Romania
12
Department of Pathophysiology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
13
Department of Surgery, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
14
Department of Vascular Surgery, “St. Spiridon” County Clinical Emergency Hospital, 700111 Iasi, Romania
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Nutrients 2024, 16(12), 1972; https://doi.org/10.3390/nu16121972
Submission received: 19 May 2024 / Revised: 13 June 2024 / Accepted: 18 June 2024 / Published: 20 June 2024

Abstract

Branched-chain amino acids (BCAAs), comprising leucine (Leu), isoleucine (Ile), and valine (Val), are essential nutrients vital for protein synthesis and metabolic regulation via specialized signaling networks. Their association with cardiovascular diseases (CVDs) has become a focal point of scientific debate, with emerging evidence suggesting both beneficial and detrimental roles. This review aims to dissect the multifaceted relationship between BCAAs and cardiovascular health, exploring the molecular mechanisms and clinical implications. Elevated BCAA levels have also been linked to insulin resistance (IR), type 2 diabetes mellitus (T2DM), inflammation, and dyslipidemia, which are well-established risk factors for CVD. Central to these processes are key pathways such as mammalian target of rapamycin (mTOR) signaling, nuclear factor kappa-light-chain-enhancer of activate B cells (NF-κB)-mediated inflammation, and oxidative stress. Additionally, the interplay between BCAA metabolism and gut microbiota, particularly the production of metabolites like trimethylamine-N-oxide (TMAO), adds another layer of complexity. Contrarily, some studies propose that BCAAs may have cardioprotective effects under certain conditions, contributing to muscle maintenance and metabolic health. This review critically evaluates the evidence, addressing the biological basis and signal transduction mechanism, and also discusses the potential for BCAAs to act as biomarkers versus active mediators of cardiovascular pathology. By presenting a balanced analysis, this review seeks to clarify the contentious roles of BCAAs in CVD, providing a foundation for future research and therapeutic strategies required because of the rising prevalence, incidence, and total burden of CVDs.
Keywords: branched-chain amino acids; cardiovascular diseases; heart failure; type 2 diabetes; insulin resistance; mammalian target of rapamycin (mTOR) branched-chain amino acids; cardiovascular diseases; heart failure; type 2 diabetes; insulin resistance; mammalian target of rapamycin (mTOR)
Graphical Abstract

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MDPI and ACS Style

Tanase, D.M.; Valasciuc, E.; Costea, C.F.; Scripcariu, D.V.; Ouatu, A.; Hurjui, L.L.; Tarniceriu, C.C.; Floria, D.E.; Ciocoiu, M.; Baroi, L.G.; et al. Duality of Branched-Chain Amino Acids in Chronic Cardiovascular Disease: Potential Biomarkers versus Active Pathophysiological Promoters. Nutrients 2024, 16, 1972. https://doi.org/10.3390/nu16121972

AMA Style

Tanase DM, Valasciuc E, Costea CF, Scripcariu DV, Ouatu A, Hurjui LL, Tarniceriu CC, Floria DE, Ciocoiu M, Baroi LG, et al. Duality of Branched-Chain Amino Acids in Chronic Cardiovascular Disease: Potential Biomarkers versus Active Pathophysiological Promoters. Nutrients. 2024; 16(12):1972. https://doi.org/10.3390/nu16121972

Chicago/Turabian Style

Tanase, Daniela Maria, Emilia Valasciuc, Claudia Florida Costea, Dragos Viorel Scripcariu, Anca Ouatu, Loredana Liliana Hurjui, Claudia Cristina Tarniceriu, Diana Elena Floria, Manuela Ciocoiu, Livia Genoveva Baroi, and et al. 2024. "Duality of Branched-Chain Amino Acids in Chronic Cardiovascular Disease: Potential Biomarkers versus Active Pathophysiological Promoters" Nutrients 16, no. 12: 1972. https://doi.org/10.3390/nu16121972

APA Style

Tanase, D. M., Valasciuc, E., Costea, C. F., Scripcariu, D. V., Ouatu, A., Hurjui, L. L., Tarniceriu, C. C., Floria, D. E., Ciocoiu, M., Baroi, L. G., & Floria, M. (2024). Duality of Branched-Chain Amino Acids in Chronic Cardiovascular Disease: Potential Biomarkers versus Active Pathophysiological Promoters. Nutrients, 16(12), 1972. https://doi.org/10.3390/nu16121972

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