Carnitine and its role in cardiovascular disease

L-carnitine and its derivative, propionyl-L-carnitine, are organic amines produced and metabolized endogenously. These compounds are essential in the process of fatty acid oxidation and have also been shown to reduce intracellular accumulation of toxic metabolites during ischemia. Currently, exogenous administration of carnitine is indicated only as therapy for primary and secondary carnitine deficiency. However, it has been hypothesized that because of its ability to enhance energy production and remove toxic metabolites during ischemia, carnitine therapy may be useful in the treatment of various cardiac diseases. In fact, there is increasing evidence that endogenous carnitine has beneficial effects in the treatment of congestive heart failure, arrhythmia, peripheral vascular disease, and acute ischemia.