Carnitine Shuttle Purpose and Mechanism Carnitine metabolism in hypertensive heart failure Hypertension Research Short Note On Carnitine Shuttle: Fatty acids are oxidized in mitochondria, and synthesized in the cytoplasm. Long chain fatty acids must form an active intermediate, fatty acyl CoA, before being oxidized inside mitochondria. Catherine L Carnitine functions as a cofactor for long chain fatty acids across Download Scientific Diagram Frontiers Fatty acid oxidation in immune function