Carnitine levels in patients with chronic rheumatic heart disease

Objective: Carnitine, a small aminoacid derivative plays a major role in fatty acid oxidation. Myocardial carnitine deficiency may cause malfunction of the heart. Rheumatic valvular heart disease can be associated with myocardial dysfunction. We have investigated myocardial and plasma-free carnitine levels in patients with chronic rheumatic heart disease. Material and Methods: Eleven patients with chronic rheumatic heart disease requiring valve replacement were selected for study. Ten patients with no cardiac failure, myocardial wall motion abnormalities and myocardial infarction and for whom coronary bypass surgery was planned were selected as the control group. Carnitine levels of myocardial tissue obtained from the right atrium and plasma during the operation were evaluated using spectrophotometric method. Myocardial-free carnitine levels expressed as mu mol/g (dry weight) were determined according to Ceberblad and Lindstedt technique. Results: Myocardial-free carnitine levels in patients were found to be 0.72 +/- 0.37 mu mol/g (dry weight) in comparison with 1.44 +/- 1.03 mu mol/g (dry weight) in the control group. Myocardial-free carnitine levels in patients were statistically decreased when compared to control group. Plasma-free carnitine levels in patients were 80.91 +/- 28.22 mu mol/L and 89.52 +/- 48.21 mu mol/L in the control group, respectively. There was no significant difference between plasma-free carnitine levels of the groups. Conclusion: In our study, myocardial-free carnitine levels were decreased while plasma-free carnitine levels were normal in patient with chronic rheumatic heart disease.