“Mitochondrial remodeling” in coronary heart disease Masao Saotome,1 György Hajnóczky,2 Hideki Katoh,1 Hiroshi Satoh,1 Hideharu Hayashi11Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu, Japan; 2Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University, Philadelphia, PA, USAAbstract: Coronary heart disease is a major cause of morbidity and mortality in advanced countries. Despite remarkable developments and achievements in the field of coronary intervention, such as percutaneous catheter intervention and coronary bypass surgery, the mortality from coronary heart disease remains high because of lack of effective cardioprotective therapy against ischemia/reperfusion injury after coronary recanalization. The mitochondria play a crucial role in determination of cell death in ischemia/reperfusion injury, and furthermore provide myocardial protection against ischemia/reperfusion injury by ischemic preconditioning. Functional and structural alterations in the mitochondria help to decide cell death and survival, and many investigations have been conducted to explore the pathophysiological mechanisms of “mitochondrial remodeling” to gain clues regarding ischemia/reperfusion injury. In this review, we summarize the current state of knowledge concerning the pathophysiological role of bidirectional (detrimental and defensive) “mitochondrial remodeling” via which cell death or survival is determined in coronary heart disease. Further, we discuss clinical trials of mitochondria-targeted treatment in patients with coronary heart disease.Keywords: coronary heart disease, mitochondrial remodeling, mitochondrial dynamics