Remodeling of cardiac metabolism in heart failure with preserved ejection fraction

The remodeling of cardiac metabolism, such as changes in substrate utilization and mitochondrial dysfunction, has long been suggested to impair myocardial energetics that leads to energy starvation of the failing hearts. However, most of the studies to date focused on heart failure with reduced ejection fraction and the role of metabolism in the development of heart failure with preserved ejection fraction (HFpEF) is thus not well defined. Studies of cardiac metabolism in HFpEF are emerging with the recent progress in animal models. This review seeks to provide an overview of metabolic profile in HFpEF hearts from available reports and to highlight future research directions.