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Nowhere is this balance more important and more precarious than in the heart. This highly energy-demanding muscle normally oxidizes almost all the available substrates to generate energy, with fatty acids being the preferred source under physiological conditions.<\/jats:p>\n                  <jats:p>In patients with cardiomyopathies and heart failure, changes in the main energetic substrate are observed; these hearts often prefer to utilize glucose rather than oxidizing fatty acids. An imbalance between uptake and oxidation of fatty acid can result in cellular lipid accumulation and cytotoxicity. In this review, we will focus on the sources and uptake pathways used to direct fatty acids to cardiomyocytes. We will then discuss the intracellular machinery used to either store or oxidize these lipids and explain how disruptions in homeostasis can lead to mitochondrial dysfunction and heart failure. Moreover, we will also discuss the role of cholesterol accumulation in cardiomyocytes. Our discussion will attempt to weave in vitro experiments and in vivo data from mice and humans and use several human diseases to illustrate metabolism gone haywire as a cause of or accomplice to cardiac dysfunction.<\/jats:p>","DOI":"10.1093\/cvr\/cvad100","type":"journal-article","created":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T14:37:34Z","timestamp":1688222254000},"page":"1905-1914","source":"Crossref","is-referenced-by-count":270,"title":["Cardiac lipid metabolism, mitochondrial function, and heart failure"],"prefix":"10.1093","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6298-8689","authenticated-orcid":false,"given":"Lorenzo","family":"Da Dalt","sequence":"first","affiliation":[{"name":"Department of Pharmacological and Biomolecular Sciences, University of Milan , Via Balzaretti 9, Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4026-7637","authenticated-orcid":false,"given":"Ainara G","family":"Cabodevilla","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, New York University Grossman School of Medicine, 550 1st Ave., New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ira J","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, New York University Grossman School of Medicine, 550 1st Ave., New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6081-1257","authenticated-orcid":false,"given":"Giuseppe Danilo","family":"Norata","sequence":"additional","affiliation":[{"name":"Department of Pharmacological and Biomolecular Sciences, University of Milan , Via Balzaretti 9, Milan ,","place":["Italy"]},{"name":"Center for the Study of Atherosclerosis, E. 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