Protein acylation and heart failure: A review of novel lysine modifications in cardiac pathology

Pathological cardiac hypertrophy is a primary contributor to heart failure (HF). Protein acylation, particularly acetylation, plays a crucial role in this process. Advances in mass spectrometry and proteomics have identified an increasing number of novel lysine acylation modifications, including crotonylation, lactylation, succinylation, β-hydroxybutyrylation, 2-hydroxyisobutyrylation, propionylation and malonylation. These novel acylations are implicated in key physiological processes and disease-related cellular functions, as they modify the physicochemical properties of proteins and closely link substrate metabolism to gene regulation. Research on these novel lysine acylations associated with cardiac hypertrophy and HF has been steadily increasing in recent years. This review aims to summarize the progress and significance of these novel lysine acylations in cardiac hypertrophy and HF, providing references for a deeper understanding of the pathogenesis of HF and development of innovative therapeutic strategies.