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In due time, the Brazilian Society of Cardiology decided to create a guideline on telemedicine applied to cardiology, also known as telecardiology. According to the Pan American Health Organization (PAHO) and the World Health Organization (WHO), telemedicine is “The delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment, and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities.” Such a seemingly simple and altruistic definition carries a wide range of potential implications at various levels, from an ethical point of view to a potential impact on clinical practice and outcomes. Hence, the importance of guidelines, organized by the medical community through scientific societies, in offering to all of those involved in the process a reference based, as much as possible, on expert opinion, current scientific evidence, and on respect for medical ethical and deontological values. Oportunamente, a Sociedade Brasileira de Cardiologia decidiu criar uma diretriz sobre a telemedicina aplicada à cardiologia, também conhecida como telecardiologia. Segundo a Organização Pan-Americana da Saúde (OPAS) e a Organização Mundial da Saúde (OMS), a telemedicina é “A prestação de serviços de saúde, onde a distância é um fator crítico, por todos os profissionais de saúde que utilizam tecnologias de informação e comunicação para a troca de informações válidas para diagnóstico, tratamento e prevenção de doenças e lesões, pesquisa e avaliação, e para a educação continuada dos profissionais de saúde, tudo no interesse do avanço da saúde dos indivíduos e de suas comunidades”. Tal definição aparentemente simples e altruísta carrega uma ampla gama de implicações potenciais em vários níveis, desde um ponto de vista ético até um potencial impacto na prática clínica e nos resultados. Daí a importância das diretrizes, organizadas pela comunidade médica por meio das sociedades científicas, em oferecer a todos os envolvidos no processo uma referência baseada, tanto quanto possível, na opinião de especialistas, nas evidências científicas atuais e no respeito à ética médica e valores deontológicos.

The heart has an intense aerobic metabolism and is among the most metabolically active organs in the body. Its tissue stores fatty acid, the main energetic substrate, and requires high concentrations of plasma L-carnitine. This nutrient is essential in the transport of fatty acids to the mitochondria to generate energy and maintain the proper concentration of coenzyme A free. In decompensated chronic heart failure metabolic changes, associated with inflammation, alter the metabolism of L-carnitine and compromise cardiac energy metabolism. The aim of this study was to evaluate plasma L-carnitine in chronic heart failure patients during cardiac decompensation. A cross-sectional study was conducted with 109 volunteers with chronic heart failure. Participants were stratified in the compensated (HF compensated) and decompensated (decompensated HF) groups. Plasma L-carnitine was evaluated by the spectrophotometric enzymatic method. Low plasma L-carnitine was found in the decompensated HF group (p = 0.0001). In this group it was also observed that 29.1% of the participants presented plasma L-carnitine below the reference range (20 mmol). Reduced plasma L-carnitine in patients with decompensated chronic systolic heart failure was founded. These findings suggest that plasma L-carnitine assessment may be helpful in clinical practice for the treatment of patients with cardiac decompensation.