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Plasma carnitine concentrations in patients undergoing open heart surgery
Shintaro Nemoto1, Kiyomitsu Yasuhara, Katsutoshi Nakamura
1Department of Cardiovascular Surgery, Seirei Hamamatsu General Hospital, Shizuoka, Japan.
Summary
Open heart surgery significantly depletes free carnitine levels, crucial for cardiac energy. Carnitine supplementation may benefit patients recovering from cardiopulmonary bypass.
Area of Science:
- Biochemistry
- Cardiology
- Metabolic Medicine
Background:
- Carnitine is vital for fatty acid metabolism and ATP production in the heart.
- Myocardial ischemia impairs fatty acid metabolism and depletes cardiac carnitine.
- The heart lacks carnitine synthesis, making plasma carnitine critical during reperfusion.
Purpose of the Study:
- To investigate abnormal plasma carnitine concentrations in patients undergoing open heart surgery.
- To assess the impact of cardiopulmonary bypass on carnitine levels.
Main Methods:
- Blood samples collected from eleven open heart surgery patients.
- Measurements taken pre-surgery, immediately post-cardiopulmonary bypass (CPB), and two hours after CPB.
- Analysis of total, free, and acyl carnitine levels.
Main Results:
- Significant reductions in total and free carnitine levels were observed immediately after CPB (p<0.01).
- These depressed levels persisted for two hours post-CPB (p<0.01 vs. pre-CPB).
- Acyl carnitine levels remained unchanged throughout the study period.
Conclusions:
- Open heart surgery and CPB lead to significant depletion of myocardial free carnitine.
- Reduced free carnitine may negatively impact cardiac metabolism post-surgery.
- Carnitine supplementation could be a beneficial therapy for post-open heart surgery patients.