Fatty acid homeostasis in cardiac tissue is characterized by a variety of chemical and physical processes, the interrelationship and regulating factors of which are only partially elucidated. Various storage forms of fatty acids are present, while numerous lipid-converting enzymes and transport routes are involved (25, 254, 392,440).

A large portion of the circulatory fatty acyl moieties is delivered to the heart as a complex with plasma albumin (134,135). An additional part is released from triacylglycerol-containing lipoprotein particles after hydrolysis by lipoprotein lipase, which is attached to the luminal surface of the endothelial cell membrane (98, 549). Fatty acids then successively transverse the endothelium, the interstitial space, and the sarcolemma of the cardiomyocyte. Inside the myocyte a specific fatty acid-binding protein (FABP) is probably involved in the transport of fatty acids from the sarcolemma to the mitochondria and other cytoplasmic sites of conversion.