The Failing Heart — An Engine Out of Fuel.

The article discusses heart failure, with a focus on cardiac energy metabolism. Components of cardiac energy metabolism are described, including the components of substrate utilization, oxidative phosphorylation, and adenosine triphosphate transfer and utilization. The creatine kinase system is also discussed. Nuclear-receptor transcription factors are described as molecular regulators of energy metabolism. Genetic studies, including gene-knockout models, can be used to study chronic heart failure. Treatment options of chronic heart failure that focus on energy metabolism are described.