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The following medical subject headings were used: L-carnitine, carnitine, levocarnitine, novain, L-cthernitine, Vitamin BT, Bicarnesine, heart failure, cardiac dysfunction, cardiac insufficiency, cardiac inadequacy, cardiomyopathy, and ventricular dysfunction. Electronic searches were supplemented with manual searches of reference lists of all retrieved review articles, primary studies, and abstracts from meetings to identify other studies not found in the electronic searches

Numerous studies show a positive correlation between the level of TMAO concentration and the onset of several illnesses, including diabetes mellitus, hypertension, ischemic stroke, atrial fibrillation (AF), heart failure (HF), acute myocardial infarction (MI), and chronic kidney disease (CKD) [5]

Stable isotope dilution LC-MS/MS was used to quantify d 9 -TMAO ( A ), d 9 -BB ( B ), and d 9 -l-carnitine ( C ) in plasma collected from sequential venous blood draws at the noted times

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