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Regular physical activity, especially during fasting periods or before meals, increases fatty acid mobilization and creates the conditions where enhanced carnitine-mediated transport could theoretically make a difference

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On the other hand, in HF patients, cardiac energy metabolism is shifted from fatty acid oxidation to glucose, and carnitine insufficiency in the failing myocardium is caused by the leakage of carnitine through damaged cardiomyocyte membranes [4]