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For more than two millenniums, the beating heart is considered as a sign and symbol of life and vitality. Due to its central role for the individual life, both scientists as well as philosophers were engaged evolving concepts to explain cardiac function. This review gives an outline about the research performed and the concepts set up that finally yielded our current understanding of myocardial energy metabolism as integral part of cardiac function. From simple experiments performed by early physiologists to highly sophisticated techniques currently employed, the researchers step by step succeeded in developing detailed and unifying concepts to explain cardiac function in physiological as well as in various pathological conditions. By elucidating cardiac energy metabolism in the failing heart, however, the scientists' explanations became almost as manifold as the setup and / or model used for investigation. This diversity did so far not allow to formulate an unifying metabolic hypothesis of heart failure, though the divergent results and concepts may fit to the clinical view, considering cardiac failure as the final stage of numerous cardiac diseases. |
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