In contrast to findings during ischemia where GLUT 4 was found to be translocated from intracellular vesicles to the plasma membrane together with its up regulation and switch of their primary substrate from fatty acids to glucose to facilitate anaerobic gycolysis25 in the present study GLUT 4 on the sarcolemma of cardiomyocytes was decreased. The gene discussed is SLC2A4; the disease is ischemia.