The Third International Symposium on Lipid Metabolism in the Normoxic and Ischemic Heart was held in Rotterdam, the Netherlands, September 9-10, 1991. The topics of this meeting were focused on: 1. Modulation of myocardial lipid metabolism, 2. Biological membranes; structure, functiona and turnover, 3. Pharmacological modification of myocardial fatty acid oxidation, 4. Myocardial vascular endothelium; contribution to myocardial lipid homeostasis. Special attention is given to the interrelationship between carbohydrates and fatty acids as energy substrates for the heart under normoxic and (post) ischemic circumstances, the influence of diets, varying in their fatty acid composition, on cardiac function, and the significance of phospholipid topology, turnover, and methylation in general and the phosphatidylinositol pathway in particular on performance of the heart. The role of carnitine in cardiac function altered by lack of oxygen or by elevated levels of fatty acyl derivatives of carnitine and the modulatory effects of the endothelium on cardiac lipid homeostasis were also extensively discussed during the conference. This focused Issue of is a collection of invited papers based on the lectures and a selection of posters presented during the meeting. It includes contributions of renowned investigators delineating recent results and discussing significant aspects of their data in an attempt to enlarge our insight in the complexity of cardiac lipid transport and metabolism, in the healthy and diseased myocardium.