Metabolism of the Heart in Failure

H EART failure imav be conisidered fromn a Variety of viewpoints and studied by diverse nmethods. Researfh inlto the clinieal ancd hemnodynaimie aspeets of congestive failure has uineovered inuch useful informnation; however, the basic question remuains unanswered: What changes in the imvocardiunm lead to deficient emyiptying of the heart anid thenee to heart failure In reelent years, modern technies have made possible direct study, of the cardiac mausele in attenmpts to understand how it converts energy derived fromn substrates imito useful work amid to uncover derangemnents that nmay lead to insufficielley anld failure of the heart. While this problem is far frolm solved, progress hlas been made and unresolved questions have been brought into sharper focus.