Morash AJ, Kotwica AO, Murray AJ. Tissue-specific changes in fatty acid oxidation in hypoxic heart and skeletal muscle. Am J Physiol Regul Integr Comp Physiol 305: R534 -R541, 2013. First published June 19, 2013 doi:10.1152/ajpregu.00510.2012.-Exposure to hypobaric hypoxia is sufficient to decrease cardiac PCr/ATP and alters skeletal muscle energetics in humans. Cellular mechanisms underlying the different metabolic responses of these tissues and the time-dependent nature of these changes are currently unknown, but altered substrate utilization and mitochondrial function may be a contributory factor. We therefore sought to investigate the effects of acute (1 day) and more sustained (7 days) hypoxia (13% O 2) on the transcription factor peroxisome proliferator-activated receptor ␣ (PPAR␣) and its targets in mouse cardiac and skeletal muscle. In the heart, PPAR␣ expression was 40% higher than in normoxia after 1 and 7 days of hypoxia. Activities of carnitine palmitoyltransferase (CPT) I and -hydroxyacyl-CoA dehydrogenase (HOAD) were 75% and 35% lower, respectively, after 1 day of hypoxia, returning to normoxic levels after 7 days. Oxidative phosphorylation respiration rates using palmitoyl-carnitine followed a similar pattern, while respiration using pyruvate decreased. In skeletal muscle, PPAR␣ expression and CPT I activity were 20% and 65% lower, respectively, after 1 day of hypoxia, remaining at this level after 7 days with no change in HOAD activity. Oxidative phosphorylation respiration rates using palmitoyl-carnitine were lower in skeletal muscle throughout hypoxia, while respiration using pyruvate remained unchanged. The rate of CO2 production from palmitate oxidation was significantly lower in both tissues throughout hypoxia. Thus cardiac muscle may remain reliant on fatty acids during sustained hypoxia, while skeletal muscle decreases fatty acid oxidation and maintains pyruvate oxidation. fatty acids; mitochondrial respiration; hypoxia; metabolism; heart HYPOBARIC HYPOXIA elicits a myriad of physiological responses that aim to increase oxygen availability at the tissues or decrease tissue oxygen demand (42). Central to this response is an acute increase in cardiac output, which in the face of atmospheric hypoxia can lead to an inability to match oxygen demand at the heart tissue itself (17). In a study of humans returning from exposure to hypobaric hypoxia at high altitude, resting energy levels were maintained in the subjects' skeletal muscle (9), whereas their hearts showed impaired energetics as indicated by decreased PCr/ATP (17). The cellular mechanisms underlying the different responses of these two tissues are unknown; however, the process of metabolic remodelling may differ under hypoxic conditions, and it has been suggested that altered substrate selection and mitochondrial respiration may be key factors in this regard (23,38,50).In the healthy heart, 90% of ATP production is generated via mitochondrial oxidative phosphorylation with 60 -70% of that energy being derived from lipid oxidation (3...