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Pathological hypertrophy, in contrast, is commonly linked to hypertension, valvular disease, diabetes, obesity, cardiomyopathy, renal disease, or aging and may progress to fibrosis, capillary rarefaction, diastolic dysfunction, systolic failure, arrhythmia, and sudden death ( The adult heart has high ATP demand and normally oxidizes multiple substrates, especially fatty acids, glucose, lactate, ketone bodies, and amino acids