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Published on: September 28, 2016
l-Carnitine and heart disease
Zhong-Yu Wang1, Ying-Yi Liu2, Guo-Hui Liu1
1Department of Cardiology, China-Japan Union Hospital, Jilin University, Changchun, PR China.
Insights
L-carnitine, a vital cofactor, offers a promising alternative to traditional cardiovascular disease drugs by supporting heart energy metabolism and protecting cardiac cells. Its administration combats various heart conditions and associated risk factors.
Area of Science:
- Cardiology and Metabolic Disorders
- Mitochondrial Function and Energy Metabolism
- Pharmacology and Therapeutics
Background:
- Cardiovascular disease (CVD) is a leading global cause of mortality, with significant healthcare costs.
- Current CVD treatments like beta-blockers and ACE inhibitors have adverse effects, necessitating alternative strategies.
- Carnitine depletion, linked to CVD, highlights the importance of carnitine in cardiac health.
Purpose of the Study:
- To explore l-carnitine as a cardioprotective agent and alternative therapeutic strategy for cardiovascular diseases.
- To elucidate the mechanisms by which l-carnitine influences cardiac energy metabolism and cellular homeostasis.
- To review the efficacy of l-carnitine in managing various cardiovascular pathologies and associated metabolic conditions.
Main Methods:
- Review of existing literature on l-carnitine's role in cardiovascular health.
- Analysis of l-carnitine's biochemical pathways, including mitochondrial beta-oxidation and fatty acid transport.
- Examination of clinical evidence supporting l-carnitine's benefits in different patient populations and conditions.
Main Results:
- l-Carnitine enhances mitochondrial beta-oxidation, balancing cardiac energy metabolism and providing cardioprotection.
- It reduces oxidative stress, inflammation, and myocyte necrosis, while regulating cellular homeostasis.
- Exogenous l-carnitine administration demonstrates efficacy against ventricular dysfunction, ischemia-reperfusion injury, and arrhythmias.
Conclusions:
- l-Carnitine is a safe and effective therapeutic agent for various cardiovascular conditions, including cardiomyopathy.
- It mitigates cardiovascular risk factors such as hypertension, hyperlipidemia, and diabetes.
- l-Carnitine supplementation represents a valuable strategy for preventing and treating cardiovascular diseases across all age groups.
Abstract:
Cardiovascular disease (CVD) is a key cause of deaths worldwide, comprising 15-17% of healthcare expenditure in developed countries. Current records estimate an annual global average of 30 million cardiac dysfunction cases, with a predicted escalation by two-three folds for the next 20-30years. Although β-blockers and angiotensin-converting-enzymes are commonly prescribed to control CVD risk, hepatotoxicity and hematological changes are frequent adverse events associated with these drugs. Search for alternatives identified endogenous cofactor l-carnitine, which is capable of promoting mitochondrial β-oxidation towards a balanced cardiac energy metabolism. l-Carnitine facilitates transport of long-chain fatty acids into the mitochondrial matrix, triggering cardioprotective effects through reduced oxidative stress, inflammation and necrosis of cardiac myocytes. Additionally, l-carnitine regulates calcium influx, endothelial integrity, intracellular enzyme release and membrane phospholipid content for sustained cellular homeostasis. Carnitine depletion, characterized by reduced expression of "organic cation transporter-2" gene, is a metabolic and autosomal recessive disorder that also frequently associates with CVD. Hence, exogenous carnitine administration through dietary and intravenous routes serves as a suitable protective strategy against ventricular dysfunction, ischemia-reperfusion injury, cardiac arrhythmia and toxic myocardial injury that prominently mark CVD. Additionally, carnitine reduces hypertension, hyperlipidemia, diabetic ketoacidosis, hyperglycemia, insulin-dependent diabetes mellitus, insulin resistance, obesity, etc. that enhance cardiovascular pathology. These favorable effects of l-carnitine have been evident in infants, juvenile, young, adult and aged patients of sudden and chronic heart failure as well. This review describes the mechanism of action, metabolism and pharmacokinetics of l-carnitine. It specifically emphasizes upon the beneficial role of l-carnitine in cardiomyopathy.
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