FIG. 11.

Cardiac mitochondrial metabolism of different substrates in the normal state and in the pathological state (ischemia). In normal cardiomyocytes, cellular metabolism derives mostly from fatty acid metabolism. The transport of fatty acyl-CoA into mitochondria is accomplished via CPT 1. Once inside mitochondria, the fatty-CoA is a substrate for β-oxidation. During ischemia, substrate utilization is derived mostly from glucose and is less dependent on fatty acid metabolism. Ca²⁺ uptake through the Ca²⁺ uniporter (CaU) is thought to regulate TCA cycle enzyme activity. In the ischemic condition, Ca²⁺ uptake may occur via mPTP opening and other nonphysiological means (e.g., OMM permeabilization). Reproduced with permission and modified from Stark and Roden (540).