Figure 1

Glucose and fatty acid metabolism in the cardiomyocyte. Glucose uptake into the cell occurs through the glucose transporters GLUT1 and GLUT4. Once inside, glucose is broken down into pyruvate by glycolysis. Pyruvate is subsequently transported into the mitochondria and decarboxylated to acetyl-CoA. Non-esterified fatty acids are taken up through fatty acid transporter (FAT)/CD36, fatty acid transport protein (FATP) and plasma membrane fatty acid binding protein (FABPpm). Intracellular fatty acids form fatty acyl-CoA and can either be esterified into triglycerides (TG) or enter the mitochondria via carnitine palmitoyl transferase (CPT-1). Fatty acyl-CoA enters the β-oxidation pathway, forming acetyl-CoA. Glucose or fatty acid-derived acetyl-CoA enters the tricarboxylic acid (TCA) cycle with entry of reducing equivalents to the electron transport chain and oxidative phosphorylation, and finally ATP is formed.