Heart failure (HF) is a global public health problem with high morbidity and mortality. A large number of studies have shown that HF is caused by severe energy metabolism disorders, which result in an insufficient heart energy supply. This deficiency causes cardiac pump dysfunction and systemic energy metabolism failure, which determine the development of HF and recovery of heart. Current HF therapy acts by reducing heart rate and cardiac preload and afterload, treating the HF symptomatically or delaying development of the disease. Drugs aimed at cardiac energy metabolism have not yet been developed. In this review, we outline the main characteristics of cardiac energy metabolism in healthy hearts, changes in metabolism during HF, and related pathways and targets of energy metabolism. Finally, we discuss drugs that improve cardiac function via energy metabolism to provide new research ideas for the development and application of drugs for treating HF.

心力衰竭（HF）是高发病率和高死亡率的全球性公共卫生问题。大量研究表明，HF是由严重的能量代谢紊乱引起的，从而导致心脏能量供应不足。这种缺乏会导致心脏泵功能障碍和全身能量代谢衰竭，从而决定心衰的发展和心脏的恢复。当前的HF疗法通过降低心率和心脏前负荷和后负荷，对症治疗HF或延缓疾病的发展而起作用。尚未开发出针对心脏能量代谢的药物。在这篇综述中，我们概述了健康心脏中心脏能量代谢的主要特征，HF期间的代谢变化以及能量代谢的相关途径和目标。最后，我们讨论改善心脏功能的药物通过能量代谢，为治疗HF的药物的开发和应用提供新的研究思路。