[Molecular mechanisms of the changes in myocardial energy metabolism in pathology]

The mechanism of the energy transport from the mitochondria to the sites of its utilization in the cardiac cells is discussed. This process is accomplished by creatine phosphate. The ATP synthesized in the mitochondria is utilized in the mitochondria creatine phosphokinase reaction for the synthesis of creatine phosphate and ADP which returns into the matrix for rephosphorylation. The creatine phosphate thus formed after diffusion in the cytoplasm is used in creatine phosphokinase reactions in the myofibrils and on the cell membranes for the continuous resynthesis of ATP from ADP, the product of ATP-ase reactions. Disturbance in the system of energy transport may be the direct cause of the origin of certain pathological conditions of the heart.