
New research shows that the pyruvate–lactate axis is an important regulatory node for cardiac homeostasis and function. Ahmad Cluntun and colleagues identify the mitochondrial pyruvate carrier (MPC) and the cell membrane lactate exporter monocarboxylate transporter 4 (MCT4) as crucial regulators of this axis and show that alteration of the pyruvate–lactate axis is an early event in cardiomyocyte hypertrophy and heart failure (HF).
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