mtCNPase is associated with respiratory chain complexes, and mitochondrial ATP synthase, which can lead to the release of mtCNPase from mitochondria in parallel with the release of cytochrome c, AIF, and Endo G. In addition, based on a study of the role of mtCNPase in pathological conditions, such as aging, heart failure, cancer, and alcohol addiction, we propose a scheme outlining the role of mtCNPase in these processes (Figure 5). This evidence concerns the gene ENDOG and heart failure.