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Metabolomics, the systematic study of low-molecular-weight metabolites, has emerged as a powerful approach for elucidating pathogenesis, screening candidate biomarkers, and discovering novel drug targets. Rather than merely cataloging metabolic perturbations, this review highlights how metabolic reprogramming, particularly involving amino acid pathways, mitochondrial dysfunction, and gut microbiota-derived metabolites, actively drives aortic pathology. While specific metabolites (e.g., succinate and trimethylamine N-oxide) show promises as prognostic biomarkers, their greatest value lies in revealing actionable therapeutic nodes. Although challenges remain regarding metabolite identification, biological heterogeneity, and clinical translation, continued technological advances and integrative multi-omics approaches offer clear pathways to overcome these barriers. Ultimately, we posit that prioritizing these convergent metabolic axes, especially the gut-vascular interface, could unlock next-generation precision therapies that transcend the limitations of conventional hemodynamic management.<\/jats:p>","DOI":"10.1515\/mr-2026-0010","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T21:15:02Z","timestamp":1773954902000},"page":"142-161","source":"Crossref","is-referenced-by-count":0,"title":["Metabolic reprogramming in aortic diseases: insights from metabolomics and therapeutic opportunities"],"prefix":"10.1515","volume":"6","author":[{"given":"Yingjie","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Pharmacology , Joint Laboratory of Guangdong-Hong Kong Universities for Vascular Homeostasis and Diseases, School of Medicine, Southern University of Science and Technology , Shenzhen , Guangdong , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linlu","family":"Zhao","sequence":"additional","affiliation":[{"name":"College of Pharmacy, Hainan Medical University , Haikou , Hainan , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pharmacology , Joint Laboratory of Guangdong-Hong Kong Universities for Vascular Homeostasis and Diseases, School of Medicine, Southern University of Science and Technology , Shenzhen , Guangdong , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao","family":"Ruan","sequence":"additional","affiliation":[{"name":"Department of Pharmacology , Joint Laboratory of Guangdong-Hong Kong Universities for Vascular Homeostasis and Diseases, School of Medicine, Southern University of Science and Technology , Shenzhen , Guangdong , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hualong","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Pharmacology , Joint Laboratory of Guangdong-Hong Kong Universities for Vascular Homeostasis and Diseases, School of Medicine, Southern University of Science and Technology , Shenzhen , Guangdong , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yangpo","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Pharmacology , Joint Laboratory of Guangdong-Hong Kong Universities for Vascular Homeostasis and Diseases, School of Medicine, Southern University of Science and Technology , Shenzhen , Guangdong , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenhao","family":"Ju","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences , Beijing , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5740-8010","authenticated-orcid":false,"given":"Haocheng","family":"Lu","sequence":"additional","affiliation":[{"name":"255310 School of Medicine, Southern University of Science and Technology , Shenzhen , Guangdong , China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"2026050115424112460_j_mr-2026-0010_ref_001","doi-asserted-by":"crossref","unstructured":"Quintana, RA, Taylor, WR. 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