Figure 1.

Myocardium metabolism in pathological situations: In physiological conditions, fatty acids are mainly fuel of energy of cardiomyocytes. Obesity is associated with high fatty acids uptake that develops lipotoxicity and insulin resistance. It reduces the glucose uptake. However, during hypertrophic and ischemic situation, there is shift from fatty acids to glucose that is converted into lactate. This metabolism gets less ATP production, and there is mitochondrial dysfunction and ROS (reactive oxygen species) production.