Seahorse Metabolic Analysis for Human and Mouse Cardiac Organotypic Slices

The mammalian heart relies on high rates of mitochondrial oxidative phosphorylation to meet its energy demand, with fatty acids serving as the primary fuel source in healthy adult hearts. While metabolic flexibility, the ability to switch between metabolic fuel substrates, is known to change during development and cardiac diseases, standardized methods for assessing substrate usage in intact, living cardiac tissue remain limited. Here, we present a protocol that adapts the Seahorse Mito Fuel Flex Test for use in living organotypic cardiac slices. This method enables the quantification of fuel dependency and capacity for fatty acids (FA), glucose (GLC), and glutamine (GLN) by sequentially inhibiting their respective mitochondrial oxidative phosphorylation pathways with the inhibitors etomoxir, UK5099, and BPTES. First, we validated the protocol by comparing results from organotypic cardiac slices to the standard published protocol using isolated adult mouse primary cardiomyocytes. Next, we demonstrated the sensitivity of this assay by modulating metabolism with AICAR, an AMPK activator, at varying concentrations, to demonstrate improved metabolism and then metabolic suppression at higher toxic doses. Finally, we applied this protocol to organotypic cardiac slices from different chambers of human donor hearts. This protocol provides a high-throughput, physiologically relevant platform for investigating cardiac metabolism, applicable across species and adaptable to other tissue types. It enables the study of metabolic remodeling in development and disease while overcoming the limitations of traditional cell-based assays by preserving native tissue architecture, physiology, and multicellular heterogeneity.