Giant mitochondria are frequently observed in different disease models within the brain, kidney, and liver. In cardiac muscle, these enlarged organelles are present across diverse physiological and pathophysiological conditions including in ageing and exercise, and clinically in alcohol-induced heart disease and various cardiomyopathies. This mitochondrial aberration is widely considered an early structural hallmark of disease leading to adverse organ function. In this thematic paper, we discuss the current state-of-knowledge on the presence, structure and functional implications of giant mitochondria in heart muscle. Despite its demonstrated reoccurrence in different heart diseases, the literature on this pathophysiological phenomenon remains relatively sparse since its initial observations in the early 60s. We review historical and contemporary investigations from cultured cardiomyocytes to human tissue samples to address the role of giant mitochondria in cardiac health and disease. Finally, we discuss their significance for the future development of novel mitochondria-targeted therapies to improve cardiac metabolism and functionality.

在大脑、肾脏和肝脏的不同疾病模型中经常观察到巨大的线粒体。在心肌中，这些增大的细胞器存在于多种生理和病理生理条件下，包括衰老和运动，以及临床上酒精引起的心脏病和各种心肌病。这种线粒体畸变被广泛认为是导致器官功能不良的疾病的早期结构标志。在这篇专题论文中，我们讨论了心肌中巨型线粒体的存在、结构和功能影响的当前知识状况。尽管它在不同的心脏病中反复出现，但自 20 世纪 60 年代初首次观察以来，关于这种病理生理现象的文献仍然相对较少。我们回顾了从培养的心肌细胞到人体组织样本的历史和当代研究，以探讨巨型线粒体在心脏健康和疾病中的作用。最后，我们讨论了它们对于未来开发新型线粒体靶向疗法以改善心脏代谢和功能的重要性。