Is AMPK the savior of the failing heart?

• Heart failure is one of the leading causes of death worldwide.
• A decline in cardiac energy metabolism contributes to heart failure pathogenesis.
• AMPK has a major role in the regulation of cardiac energy metabolism.
• Pharmacological activation of AMPK may be useful in the treatment of heart failure.

Heart failure (HF) is one of the leading causes of death, affecting more than 20 million people worldwide. A vast array of pathophysiological and molecular events contributes to the development and eventual worsening of HF. Of these, defects in myocardial metabolic processes that normally result in proper ATP production necessary to maintain contractile function appear to be a major contributor to HF pathogenesis. A key player involved in regulating myocardial metabolism is AMP-activated protein kinase (AMPK), a major regulatory kinase controlling numerous metabolic pathways. Here, we review the metabolic changes that occur in HF, what role alterations in energy metabolism has in its progression, and the involvement of AMPK in this context.