Fatty acids released from adipose tissues during fasting accumulate in various organs predisposing to their impaired function.[5][6] Accumulation of fat in the liver causes steatosis and impairment of ketone body production.[5][6][8] In the heart and skeletal muscles, this abnormal accumulation results in cardiomyopathy and myopathy respectively.[5][6] Heart derives two-thirds of its energy from free fatty acids and this predisposes patients with impaired carnitine metabolism to the development of cardiomyopathy.[6] Additionally, impaired lipid metabolism can affect the electrical rhythm of the heart resulting in arrhythmias.[6] The brain utilizes ketone bodies as an alternate energy source in fasting states
The rest of authors declare not to have any conflicts of interest that may be considered to influence directly or indirectly the content of the manuscript
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