Abstract: Chronic heart failure is the end stage of various heart diseases and its hallmark is ventricular remodeling after heart injury. The neuroendocrine activation paradigm is the cornerstone of current pathophysiological understanding of ventricular remodeling, however, there is increasing evidence that this cannot fully explain the complexity of ventricular remodeling. After the concept of myocardial metabolic remodeling was proposed, the relationship between metabolic remodeling, ventricular remodeling and heart failure has increasingly become the focus of research. Myocardial metabolic therapy targeting myocardial metabolic remodeling has become increasingly prominent in the prevention and treatment of ventricular remodeling.