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The results of another study using a lamb model with increased pulmonary blood flow showed that chronic l-carnitine treatment alleviates changes in lung carnitine homeostasis, reduces associated oxidative stress, and improves pulmonary mitochondrial function, NO signaling and eventually endothelial function [23]

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Because the beta-oxidation of fatty acids requires substantial amounts of oxygen to proceed, this hypoxic environment further stalls the mitochondrial engines