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**59**

**Chapter 4**

**Abstract**

*Dmitrii Oleinikov*

myocardial energy supply.

metabolism, heart failure

of energy substrates and ions.

to produce ATP from ADP [171].

**1. Introduction**

Myocardial Metabolism

Myocardial metabolism alterations are associated with myocardial dystrophy and lead to the heart chambers dilatation, decreased contractility, organs perfusion and depended on symptoms. Nowadays heart failure treatment in veterinary medicine includes neurohormonal, circulatory and contractile aspects of this pathological state. Unfortunately, energy supplying component not presented in modern recommendations. Most of the used medications changing contractile ability, through the control of myocardial filaments sensibility to the different ions, but don't affect the ability of cardiomyocytes to produce enough energy for this work. In order to understand the heart failure syndrome more completely, we should elucidate features, characteristics, and interactions between components of

**Keywords:** myocardial metabolism, insulin, insulin resistance, adropin, energy

The myocardium is one of the most energy-dependent structures. It demands about 6 kilograms of ATP per day [115]. In order to sustain an efficient energy supply, it has an advanced system producing enough ATP. In the organism, there are two ways to support this demand: production and accumulation. Accumulation is not suitable for the heart due to specific anatomy—most of the cytoplasms consist of myofibrils. According to this fact, in the adult heart, we observe low concentrations of ATP and many ATP-hydrolases. Total resynthesis of all ATP volume takes only 10 seconds in a normal myocardium [32, 55]. Most of the energy resources (~70%) are used for contraction and the rest—for ion pump function (K, Na, Ca pumps ATPases). This system is well coordinated, which helps to maintain the normal flux

In average, the heart consumes about 20 g of carbohydrates, 30 g of free fatty acids (FFA), and triglycerides (TG). These substrates are oxidized in 35 L of oxygen

Oxidative phosphorylation of FFA gives about 60% of all produced ATP, while

glucose, lactate, and other carbohydrates oxidation produce about 30% of all macroergic compounds. In addition, for energy supplement ketone bodies and amino acids can be utilized. Glucose utilization can be the main energy source in specific conditions (high-carbohydrate diet). Therefore, in understanding myocardial metabolic features, changes during heart failure could provide vital information for early diagnostics and therapy of myocardial diseases [99, 112]. Heart failure syndrome is a consequence of the main heart disease and associated with compensatory mechanism dysfunction, formation, and activation
