Zusammenfassung
L-Carnitin wird mit der Nahrung aufgenommen und durch den Organismus
synthetisiert. Die Hauptfunktion von L-Carnitin im Intermediärstoffwechsel
ist der Transport von Fettsäuren durch die innere Mitochondrienmembran.
Die funktionelle Bedeutung von L-Carnitin im Zusammenhang mit
kardiovaskulären Erkrankungen bietet einen Ansatzpunkt für die
Erforschung, da die Energiebereitstellung in den Myokardzellen
hauptsächlich durch die Oxidation von Fettsäuren erfolgt.
Bei Herz-Kreislauf-Erkrankungen liegt häufig ein
L-Carnitin-Mangel vor. In zahlreichen Studien wurde untersucht, ob ein
Zusammenhang zwischen kardiovaskulären Erkrankungen und L-Carnitin
besteht. Die Ergebnisse liefern Hinweise auf eine positive Korrelation. Zur
Anwendung in der Kardiologie besteht jedoch noch weiterer Forschungsbedarf.
Abstract
The substance L-carnitine is of great importance in prophylaxis and
therapy of cardiologic diseases. In contrast to the effect of omega-3 fatty
acids, which have established themselves not only in nutritive medicine for the
therapy of arrhythmia, further research on the use of L-carnitine in the case
of cardiologic problems is necessary. Considering the present studies, it has
to be assumed, that L-carnitine could play an important role in cardiology. At
least in the adjuvant therapy, the supplementation of L-Carnitine, the coenzyme
Q10, and in the case of certain heart diseases, the combination with omega-3
fatty acids is very useful.
Schlüsselwörter
L-Carnitin - Herz-Kreislauf-Erkrankungen - nutritive Medizin - Herzinsuffizienz -
Ernährung
Keywords
L-carnitine - cardiovascular diseases - nutritive medicine - heart failure - nutrition
Literatur
- 01 Beipackzettel: L-Carn® Trinklösung. Wirkstoff:
Levocarnitin. sigma-tau Arzneimittel GmbH 40211 Düsseldorf;
- 02
Bohles H, Noppeney T. et al .
The effect of preoperative L-Carnitine supplementation on
myocardial metabolism during aortocoronary bypass surgery.
Z Kardiol.
1987;
76
14-18
- 03
Cacciatore L, Cerio R. et al .
The therapeutic effect of L-Carnitine in patients with
exercise-induced stable angina: a controlled study.
Drugs Exp Clin Res.
1991;
17
225-235
- 04
Carvajal K, Moreno-Sanchez R.
Heart metabolic disturbances in cardiovascular diseases.
Arch Med Res.
2003;
34
89-99
- 05
Chazot C, Blanc C. et al .
Nutritional effects of carnitine supplementation in
hemodialysis patients.
Clin Nephrol.
2003;
59
24-30
- 06
Coker M, Coker C. et al .
Carnitine metabolism in diabetes mellitus.
J Pediatr Endocrinol.
2002;
15
841-849
- 07
Derosa G, Cicero A F. et al .
The effect of L-Carnitine on plasma Lipoprotein(a) levels in
hypercholesterolemic patients with type 2 diabetes mellitus.
Clin Ther.
2003;
25
1429-1439
- 08
Evangeliou A, Vlassopoulos D.
Carnitine metabolism and deficit – when supplementation
is necessary.
Curr Pharm Biotechnol.
2003;
4
211-219
- 09
Evans A M, Fornasini G.
Pharmakokinetics of L-Carnitine.
Clin Pharmacokin.
2003;
42
941-967
- 10
Fernandez C, Proto C.
L-Carnitine in the treatment of chronic myocardial ischemia.
An analysis of 3 multicenter studies and a bibliographic review.
Clin Ter.
1992;
140
353-377
- 11
Ferrari R, Cicchitelli G. et al .
Metabolic modulation and optimization of energy consumption
in heart failure.
Med Clin North Am.
2003;
87
493-507
- 12
Giancaterini A, Gaetano A de. et al .
Acetyl-L-Carnitine infusion increases glucose disposal in
type 2 diabetic patients.
Metabolism.
2000;
704-708
- 13
Goa K L, Brogden R N.
L-Carnitine. A preliminary review of its pharmacokinetics,
and its therapeutic ise in eschaemic cardiac disease and primary and secondary
carnitine deficiencies in relationship to its role in fatty acid
metabolism.
Drugs.
1987;
34
1-24
- 14
Guertl B, Noehammer C. et al .
Metabolic cardiomypathies.
Int J Exp Pathol.
2000;
81
349-372
- 15 Gürtler A K, Löster H. Carnitin und seine Bedeutung bei der Pathogenese und Therapie
von Herz- und Kreislauferkrankungen. Bochum; Ponte Press 1996
- 16
Helton E, Darragh R. et al .
Metabolic aspects of myocardial disease and a role for
L-Carnitine in the treatment of childhood cardiomyopathy.
Pediatrics.
2000;
105
1260-1270
- 17
Kamikawa T, Suzuki Y. et al .
Effects of L-Carnitine on exercise tolerance in patients with
stable angina pectoris.
Jpn Heart J.
1984;
25
587-597
- 18
Lango R, Smolenski r T. et al .
Influence of L-Carnitine and its derivatives on myocardial
metabolism and function in ischemic heart disease and during cardiopulmonary
bypass.
Cardovas Res.
2001;
51
21-29
- 19 Löffler G, Petrides E P. Biochemie und Pathobiochemie. 6. Aufl Berlin, Heidelberg,
New York; Springer 1998
- 20
Löster H, Miehe K. et al .
Prolonged oral L-Carnitine substitution increases bicycle
ergometer performance in patients with severe, ischemically induced cardiac
insufficiency.
Cardiovasc Drugs Ther.
1999;
537-546
- 21 Löster H. Carnitine and Cardiovascular Diseases. 1. Aufl Bochum; Ponte Press 2003
- 22
Martina B, Zuber M. et al .
Anti-arrhytmia treatment using L-Carnitine in acute
myocardial infarct.
Schweiz Med Wochenschr.
1992;
1352-1355
- 23
Mancini M, Rengo F. et al .
Controlled study on the therapeutic efficacy of
propionyl-L-Carnitine in patients with congestive heart failure.
Arzneimittelforschung.
1992;
42
1101-1104
- 24 Mehnert H, Standl E, Usadel K H. Diabetologie in Klinik und Praxis. 4. Aufl Stuttgart,
New York; Thieme 2001
- 25
Miller B, Ahmad S.
A review of the impact of L-Carnitine therapy on patient
functionality in maintenance hemodialysis.
Am J Kidney Dis.
2003;
41
44-48
- 26
Moder M, Kiessling A. et al .
The pattern of urinary acylcarnitines determined by
electrospray mass spectrometry: a new tool in the diagnosis of diabetis
mellitus.
Anal Bioanal Chem.
2003;
375
200-210
- 27
Mondillo S, Fagila S. et al .
Therapy of arrhythmia induced by myocardial ischemia.
Association of L-Carnitine, propafenone and mexiletine.
Clin Ter.
1995;
769-774
- 28
Nikolaos S, George A. et al .
Effects of L-Carnitine supplementation on red blood cells
deformability in hemodialysis patients.
Ren Fail.
2000;
22
73-80
- 29
Palazzuoli V, Mondillo S. et al .
The evaluation of the antiarrhythmic activity of L-Carnitine
and propafenone in ischemic cardiopathy.
Clin Ter.
1993;
155-159
- 30 Parsi R A, Parsi E. Kardiologie, Angiologie. 1. Aufl München, Jena; Urban & Fischer
2001
- 31
Pauly D F, Pepine C J.
The role of carnitine in myocardial dysfunction.
Am J Kidney Dis.
2003;
41
35-43
- 32 Pschyrembel W. Klinisches Wörterbuch. 257. Aufl Berlin; de Gruyter 1998
- 33
Pucciarelli G, Mastursi M. et al .
The clinical and hemodynamic effects of propionyl-L-Carnitine
in the treatment of congestive heart failures.
Clin Ter.
1992;
141
379-384
- 34 Rehner G, Daniel H. Biochemie der Ernährung. 1. Aufl Heidelberg, Berlin; Spektrum
1999
- 35
Rizos I.
Three-year survival of patients with heart failure caused by
dilated cardiomyopathy and L-Carnitine administration.
Am Heart J.
2000;
139
120-123
- 36 Rutishauser W, Hess O M. Herz und Koronarkreislauf. In: Siegenthaler W (Hrsg.):
Klinische Pathophysiologie.
8. vollständig neu bearb. Aufl Stuttgart, New York; Thieme 2001
- 37
Schreiber B D.
Congestive heart failure in patients with chronic kidney
disease and on dialysis.
Am J Med Sci.
2003;
179-193
- 38
Steiber A L, Weatherspoon L J. et al .
Serum carnitine concentrations correlated to clinical outcome
parameters in chronic hemodialysis patients.
Clin Nutr.
2004;
23
27-34
- 39
Tamamogullari N, Silig Y. et al .
Carnitine deficiency in diabetes mellitus complications.
J Diabetes Complications.
1999;
13
251-253
- 40
Vesela E, Racek J. et al .
Effect of L-Carnitine supplementation in hemodialysis
patients.
Nephron.
2001;
88
218-223
Korrespondenzadresse
Sven-David Müller
Diätassistent und Diabetesberater
DDG
Wielandstraße 3
10625 Berlin
Email: diaetmueller@web.de
URL: http://www.dkgd.de
Johannes Wüller
Facharzt für Allgemeinmedizin
Malte Rubach
M. Sc. Ernährungswissenschaft
