Abstract
Introduction: The myocardium, stressed from a variety of causes including pressure or volume overload, may develop increasing dysfunction and go on to apoptosis and remodeling. This progression produces the increasingly common problem of chronic cardiac failure (CCF). The progression has been well characterized, but what controls it is unknown. We hypothesized that the progression begins by increased cardiac load producing an unfavorable myocardial energy supply/demand ratio which leads to depressed myocardial energy levels.
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