Figure 2.

Heart failure is characterized by low energy state with a drop in CK activity and its substrate creatine. During heart failure the oxidative energy metabolism and the mitochondrial function is reduced, which is compensated by increased anaerobic glycolysis. Peripheral metabolomic profiles show often increased lactate, BCAA and L-C acylcarnitine levels. Furthermore, the failing heart’s reliance on ketone bodies is increased to compensate the reduced fatty acid oxidation in the mitochondrion. BCAA, branch-chained amino acids; CK, creatine kinase; L-C, long-chain.