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Can serum carnitine levels distinguish hypertrophic cardiomyopathy from hypertensive hearts?

T Nakamura1, H Sugihara, N Kinoshita

  • 1Second Departments of Medicine, Kyoto Prefectural University of Medicine, Japan.

Hypertension (Dallas, Tex. : 1979)
|August 19, 2000
PubMed

Insights

Serum carnitine levels can help differentiate hypertrophic cardiomyopathy (HCM) from hypertensive heart disease (HHD). Elevated free carnitine and reduced acylcarnitine in HCM patients indicate distinct fatty acid metabolism disorders.

Area of Science:

  • Cardiology
  • Biochemistry
  • Medical Imaging

Background:

  • Echocardiography can struggle to differentiate hypertrophic cardiomyopathy (HCM) from hypertensive heart disease (HHD) due to overlapping hypertrophy patterns.
  • Altered myocardial fatty acid metabolism is a characteristic of HCM.
  • Carnitine is crucial for fatty acid beta-oxidation, and its levels may reflect metabolic changes.

Purpose of the Study:

  • To investigate serum carnitine levels in patients with HCM and HHD.
  • To determine if serum carnitine levels can aid in differentiating between HCM and HHD.
  • To correlate carnitine levels with myocardial fatty acid metabolism in these conditions.

Main Methods:

  • Studied 56 patients with HCM and 20 patients with essential hypertension.
  • Measured serum free and acylcarnitine levels.
  • Utilized scintigraphy with a radioiodinated long-chain fatty acid analog to assess myocardial fatty acid metabolism.

Main Results:

  • Serum free carnitine levels were significantly higher in HCM patients (52.5+/-9.5 nmol/mL) compared to HHD patients (46.6+/-6.4 nmol/mL).
  • Serum acylcarnitine levels were significantly lower in HCM patients (10.1+/-4.0 nmol/mL) than in HHD patients (14.5+/-4.9 nmol/mL).
  • Myocardial tracer uptake, indicating fatty acid metabolism, was reduced in HCM patients compared to HHD patients.

Conclusions:

  • Differences in serum carnitine levels between HCM and HHD reflect distinct myocardial fatty acid metabolic impairments.
  • Serum carnitine levels show potential as a biomarker to differentiate between HCM and HHD.
  • These findings support the use of metabolic assessment in diagnosing cardiac conditions.

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