Nonesterified fatty acids (NEFA), glucose and lactate are major fuels for myocardial energy production. The ratio of energy produced and oxygen consumed, which can be expressed as ATP/O ratio, is different for each substrate: e.g. 3.17 for glucose and 2.83 for palmitate. Direct measurements, however, have shown that the difference of oxygen consumption is about twice as great as theoretically expected. This difference is of little significance under aerobic conditions, but may be important when oxygen supply is restricted. Numerous attempts have been made to reduce oxygen consumption by activating carbohydrate oxidation or inhibiting fatty acid metabolism. As the rate of fatty acid oxidation has been shown to depend on arterial concentrations of NEFA and albumin, this may be one point of control. Further approaches such as increasing the arterial levels of glucose, insulin and potassium, have been controversially discussed. As 4-bromocrotonic acid has been found to inhibit the fatty acid oxidation in isolated rat heart mitochondria , this might be an effective agent to save oxygen by reducing the rate of fatty acid oxidation in intact hearts.