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This cofactor is synthesized de novo in our cells from vitamin B5, also known as pantothenic acid, a water\u2010soluble vitamin abundantly present in vegetables and animal\u2010based foods. Neurodegenerative disorders, cancer, and infectious diseases have been linked to defects in de novo CoA biosynthesis or reduced levels of this coenzyme. There is now accumulating evidence that CoA limitation is a critical pathomechanism in cardiac dysfunction too. In the current review, we will summarize our current knowledge on CoA and heart failure, with emphasis on two primary cardiomyopathies, phosphopantothenoylcysteine synthetase and phosphopantothenoylcysteine decarboxylase deficiency disorders biochemically characterized by a decreased level of CoA in patients' samples. Hence, we will discuss the potential benefits of CoA restoration in these diseases and, more generally, in heart failure, by vitamin B5 and its derivatives pantethine and 4\u2032\u2010phosphopantetheine.<\/jats:p>","DOI":"10.1002\/jimd.12737","type":"journal-article","created":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T09:08:57Z","timestamp":1712653737000},"page":"885-894","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Impaired <scp>coenzyme A<\/scp> homeostasis in cardiac dysfunction and benefits of boosting <scp>coenzyme A<\/scp> production with vitamin <scp>B5<\/scp> and its derivatives in the management of heart failure"],"prefix":"10.1002","volume":"47","author":[{"given":"J. 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