Figure 1.

Metabolic alterations in heart failure and cancer. Heart failure and cancer are characterized by several overlapping changes in metabolic pathways. Both diseases are characterized by an increase in glycolysis and a decrease in oxidative respiration. Glycolytic intermediates are redirected into branch pathways for nucleotide and lipid synthesis. Alternative fuel sources are used for the Krebs cycle, a mechanism called anaplerosis, to compensate for the decreased acetyl-CoA levels for ATP production. Adjusted from DeBerardinis et al.²⁶ and Garcia-Ropero et al.²⁷