Abstract
To study the tissue carnitine level in patients with chronic heart failure, we obtained biopsy specimens of the left ventricular papillary muscle from 8 patients with mitral valve disease undergoing valve replacement surgery. As a control group autopsy specimens from 7 patients without heart disease were obtained within 4 hours of death. The free carnitine level in the heart was significantly lower in patients with chronic heart failure than in the control group (412 +/- 142 nmol/g wet tissue vs 769 +/- 267; p less than 0.01, mean +/- SD). The long-chain acylcarnitine level was significantly higher in chronic heart failure than in the control group (532 +/- 169 nmol/g wet tissue vs 317 +/- 72; p less than 0.01). The total carnitine level in chronic heart failure was similar to that in the control group (1321 +/- 170 nmol/g wet tissue vs 1315 +/- 377). These results show that in failing myocardium the fatty acid metabolism may be impaired, and administration of carnitine may be worth trying to treat chronic heart failure.
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