Summary

This chapter reviewed the metabolic pathways involved in transferring the energy in dietary carbon substrates (primarily glucose and fatty acids) to ATP, the molecule that serves as the ultimate source of energy driving contractile and other processes in the heart. Normal cardiac function depends on both adequate delivery of carbon substrates and oxygen to the heart by the coronary circulation and the ability of the heart to extract and metabolize these substrates at rates sufficient to support a wide range of ATP demands. The effects of several disease processes on cardiac metabolism were discussed, and the concept that the diseased heart may be energy limited was presented. Last, an example of effective therapy based on an understanding of an abnormal metabolic pathway emphasized the need for a strong clinical knowledge of such energetic pathways.

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