Einfluss von L-Carnitin auf das Herz - Ein Mikronährstoff mit hämodynamischen und energetischen Wirkungen auf das isolierte Langendorff-Herz

Zusammenfassung

Zur Untersuchung der Wirkungen des Mikronährstoffes L-Carnitin auf das Herz wurde das Modell des isolierten Herzens nach Langendorff verwendet. Es wurde gefunden, dass nach einer Ischämieperiode von 20 min die Wiederherstellung suffizienter hämodynamischer Parameter (bes. des linksventrikulären Druckes und des Koronarflusses) und die Wiederauffüllung der ATP- bzw. CrP-Speicher der isolierten Herzen von der Perfusatzusammensetzung abhängig ist. In der Reperfusionsphase hatten höhere Na-palmitat-Konzentrationen (1,2 vs. 0,4 mmol/l), die Anwesenheit von Glucose und die Zugabe von L-Carnitin in das Perfusat eine protektive Wirkung. L-Carnitin bewirkte bei allen Perfusatzusammensetzungen eine Verbesserung der hämodynamischen Parameter, besonders bei den Herzen, die durch einen Mangel an Fettsäuren oder Glucose gekennzeichnet waren. Acetyl- und Propionyl-L-carnitin hatten gleichsinnige, aber unterschiedliche Wirkungen im Vergleich zu L-Carnitin, wobei besonders Propionyl-L-carnitin höhere und gleichmäßigere Werte brachte, verglichen mit den Kontrollen und mit L-Carnitin.

Die positiven Ergebnisse der Untersuchungen des Einflusses von L-Carnitin und seiner kurzkettigen Ester auf das Verhalten isolierter Langendorff-Herzen deuten auf eine protektive Wirkung dieser Substanzen in der Reperfusionsperiode hin.

Summary

The effects of the micronutrient L-carnitine on the heart were investigated by means of the isolated Langendorff heart model. It could be established that the composition of the perfusate influenced both the restoration of haemodynamic parameters (particularly left-ventricular pressure and coronary flow) and the replenishing of ATP and CrP stores of the isolated heart after an ischaemic period of 20 minutes. Protective effects during reperfusion were found with higher sodium palmitate concentrations (1.2 vs 0.4), the presence of glucose or the addition of L-carnitine to the perfusate. Irrespective of the composition of the perfusate, L-carnitine effected an improvement in the haemodynamic parameters, especially in fatty acid- or glucose-deficient hearts. Similar but slightly different results were achieved with acetyl and propionyl-L-carnitine. Particularly the values produced by propionyl-L-carnitine were higher and more stable than those found with L-carnitine and the controls.

The favourable results found during the investigation of the effects of L-carnitine and its short-chain esters on isolated Langendorff hearts suggests that these substances have a protective influence during reperfusion.

L-Carnitin - Herz - hämodynamische Parameter - Reperfusion - ³¹P-NMR-Spektroskopie

L-carnitine - heart - haemodynamic parameters - reperfusion - ³¹P-NMR-spectroscopy

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