Although a shift from fatty acids (FAs) to carbohydrates (CHOs) is considered beneficial for the diseased heart, it is unclear why subjects with FA -oxidation defects are prone to cardiac decompensation under stress conditions. The present study investigated potential alterations in the myocardial utilization of CHOs for energy production and anaplerosis in 12-wkold peroxisome proliferator-activating receptor-␣ (PPAR␣) null mice (a model of FA -oxidation defects). Carbon-13 methodology was used to assess substrate flux through energy-yielding pathways in hearts perfused ex vivo at two workloads with a physiological substrate mixture mimicking the fed state, and real-time RT-quantitative polymerase chain reaction was used to document the expression of selected metabolic genes. When compared with that from control C57BL/6 mice, isolated working hearts from PPAR␣ null mice displayed an impaired capacity to withstand a rise in preload (mimicking an increased venous return as it occurs during exercise) as reflected by a 20% decline in the aortic flow rate. At the metabolic level, beyond the expected shift from FA (5-fold down) to CHO (1.5-fold up; P Ͻ 0.001) at both preloads, PPAR␣ null hearts also displayed 1) a significantly greater contribution of exogenous lactate and glucose and/or glycogen (2-fold up) to endogenous pyruvate formation, whereas that of exogenous pyruvate remained unchanged and 2) marginal alterations in citric acid cycle-related parameters. The lactate production rate was the only measured parameter that was affected differently by preloads in control and PPAR␣ null mouse hearts, suggesting a restricted reserve for the latter hearts to enhance glycolysis when the energy demand is increased. Alterations in the expression of some glycolysis-related genes suggest potential mechanisms involved in this defective CHO metabolism. Collectively, our data highlight the importance of metabolic alterations in CHO metabolism associated with FA oxidation defects as a factor that may predispose the heart to decompensation under stress conditions even in the fed state. isolated working mouse heart perfusion; citric acid cycle; 13 C isotopomer analysis; glycolysis; ATP-citrate lyase; peroxisome proliferator-activated receptor-␣ IN THE HEALTHY adult heart, the concerted regulation of longchain fatty acid (LCFA) and carbohydrate (CHO) metabolism ensures optimal energy production, in which LCFAs are often considered to be the predominant energy substrate under most conditions. This contrasts with the hypertrophied and/or failing heart, which displays a shift from LCFAs toward CHOs utilization that has been attributed, at least in part, to the deactivation of peroxisome proliferator-activated receptor-␣ (PPAR␣) (5,12,28,36,41). This nuclear transcription factor, which is highly expressed in the heart, is known to be activated by fatty acids (FAs) and to regulate the expression of genes encoding for LCFA uptake and oxidation (7). Although this shift from LCFAs to CHOs for energy production has been shown to be benef...