From the point of view of the pathophysiology of cardiovascular diseases, metabolic correction is a reasoned approach. The postulate that asserts that the contracting heart is in dire need of energy fuel is beyond doubt. Metabolic therapy (MT) of cardiology is understood to improve energy metabolism in the heart muscle by pharmacological control of the processes of energy formation and transfer at the cardiomyocyte level without affecting coronary blood flow and systemic hemodynamics. In principle, two main directions of MT can be distinguished – optimization of the processes of formation and energy consumption, as well as normalization of the balance between the intensity of free radical oxidation and antioxidant protection.