Is branched-chain amino acid nutritional supplementation beneficial or detrimental in heart failure?

Figure 1 Branched-chain amino acid and its catabolic pathway in patients with heart failure. Branched-chain amino acid (BCAA) are degraded into their final products of acetyl-CoA and succinyl-CoA, however the decrease of branched-chain keto acid (BCKA) dehydrogenase leads to the increase of BCKA. The increases of BCAAs and BCKAs potentially exacerbate heart failure. mTOR: Mammalian target of rapamycin; BCAA: Branched-chain amino acid; BCKA: Branched-chain keto acid; BCAT: Branched chain aminotransferase; ROS: Reactive oxygen species; BCKD: Branched-chain keto acid dehydrogenase; BCKDK: Branched-chain keto acid dehydrogenase kinase; BT2: 3,6-dichlorobenzo[b]thiophene-2-carboxylic acid; PP2Cm: Protein phosphatase 2C in mitochondria.