摘要成年哺乳动物心脏在损伤后很难再生，因为心肌细胞的增殖和再生潜力在出生后不久就会丧失。目前心力衰竭的治疗旨在预防心肌损伤后发生的有害重构，但尚无治疗方法可以替代丢失的心肌细胞。新生儿心肌细胞的代谢转换与心肌细胞增殖能力密切相关。代谢底物除了作为能量来源外，还是基因表达和表观遗传模式的关键调节因子。通过调控代谢底物的类型启动内源性心肌细胞增殖有望实现心脏再生修复。本综述讨论了缺氧和能量代谢重编程诱导心脏再生的研究现状，并讨论未来临床应用的前景和挑战。

abstractsIt is difficult for adult mammalian hearts to regenerate after injury because the potential for proliferation and regeneration of cardiomyocytes is lost shortly after birth. At present, the treatments of heart failure aim to prevent the harmful remodeling that occurs after myocardial injury, but there are no treatments to replace lost cardiomyocytes. The metabolic transformation of neonatal cardiomyocytes is closely related to the ability of cardiomyocyte proliferation. In addition to being a source of energy, metabolic substrates are also key regulators of gene expression and epigenetic patterns. It is expected to achieve cardiac regeneration and repair by regulating the type of metabolic substrate to initiate the proliferation of endogenous cardiomyocytes. This review discusses the research status of cardiac regeneration induced by hypoxia and energy metabolism reprogramming, and discusses the prospects and challenges of clinical application in the future.