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Moreover, studies have shown that atherosclerosis usually precedes ischemic heart disease (Panizzi et al., 2010), and that atherosclerosis induces myocardial infarction, which leads to a drastic reduction in myocardial contractility, dilation of the left ventricle, and a significant reduction in the hearts pumping capacity, which can easily lead to heart failure (Swirski and Nahrendorf, 2013)

The US National Kidney Foundation did not recommend routine administration of L-carnitine to subjects undergoing dialysis yet encouraged the development of trials in patients with select symptoms that do not respond to standard therapy, i.e., persistent muscle cramps or hypotension during dialysis, severe fatigue, skeletal muscle weakness or myopathy, cardiomyopathy, and anemia requiring large doses of erythropoietin (74, 75)

Besides intestine and kidney, OCTN2 is expressed in several tissues such as placenta, mammary gland, liver, heart, testis, skeletal muscle, and brain, where it is also expressed at the level of the blood-brain barrier (BBB

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