meostasis is altered in heart failure and may play an important role in pathogenesis. p53 has been implicated in heart failure, and although its role in regulating tumorigenesis is well characterized, its activities on cellular metabolism are just beginning to be understood. We investigated the role of p53 and its transcriptional target gene TP53-induced glycolysis and apoptosis regulator (TIGAR) in myocardial energy metabolism under conditions simulating ischemia that can lead to heart failure. Expression of p53 and TIGAR was markedly upregulated after myocardial infarction, and apoptotic myocytes were decreased by 42% in p53-deficient mouse hearts compared with those in wild-type mice. To examine the effect of p53 on energy metabolism, cardiac myocytes were exposed to hypoxia. Hypoxia induced p53 and TIGAR expression in a p53-dependent manner. Knockdown of p53 or TIGAR increased glycolysis with elevated fructose-2,6-bisphosphate levels and reduced myocyte apoptosis. Hypoxic stress decreased phosphocreatine content and the mitochondrial membrane potential of myocytes without changes in ATP content, the effects of which were prevented by the knockdown of TIGAR. Inhibition of glycolysis by 2-deoxyglucose blocked these bioenergetic effects and TIGAR siRNA-mediated prevention of apoptosis, and, in contrast, overexpression of TIGAR reduced glucose utilization and increased apoptosis. Our data demonstrate that p53 and TIGAR inhibit glycolysis in hypoxic myocytes and that inhibition of glycolysis is closely involved in apoptosis, suggesting that p53 and TIGAR are significant mediators of cellular energy homeostasis and cell death under ischemic stress.TP53-induced glycolysis and apoptosis regulator; hypoxia; metabolism; mitochondria; glycolysis DESPITE SIGNIFICANT THERAPEUTIC ADVANCES, heart failure (HF) remains a leading cause of morbidity and mortality (12, 32). Numerous studies (10, 26) have identified altered cardiac energy homeostasis as a consistent feature of HF. Recently, metabolic-based therapies have attracted much interest as a new approach for the treatment of HF. For example, a metabolic modulator, trimetazidine, shifts the energy source from free fatty acid toward predominantly glucose utilization and improves the cardiac function of patients with idiopathic dilated cardiomyopathy (35). Transgenic mice overexpressing glucose transporter (GLUT)-1 have increased glucose uptake, preserved contractile reserve, and resist the development of HF by chronic pressure overload or ischemic injury (17,20). Based on these promising findings, additional insights into the mechanisms regulating cardiac energy metabolism may be helpful for further advancing our treatment regimens.Cardiac myocytes are known to undergo apoptosis in hypoxia and ischemia-reperfusion (6, 34). Reducing apoptotic cell death and the effect of remodeling after myocardial infarction (MI) have been primary goals, as extensive MI causes severe congestive HF (15). p53 regulates apoptosis, DNA repair, cell cycle progression, and senescence in response...