Abnormalities in myocardial energy metabolism occur in association with progression to congestive heart failure. Conceivably, alterations in cardiac energy metabolism may initiate trophic responses or remodeling noted in myocardium during various disease processes. This review will explore the relationship between myocardial remodeling, contractile dysfunction, and myocardial bioenergetics. Attention will be given to data obtained from studies performed using intact animal models, which emulate congestive heart failure in humans. These data will be considered in relation to studies performed in vitro or in transgenic models. Focus will also be directed towards mechanisms of mitochondrial oxidative phosphorylation regulation (OXPHOS) and high energy phosphate transport.