L-Carnitine is a crucial component of activated fatty acid transport. The aim of this study was to evaluate the effect of L-carnitine on patients with a history of mild heart failure and diastolic dysfunction.
Twenty-nine patients with a history of NYHA functional class II symptoms and ejection fraction >45% with documented grade 1 diastolic dysfunction on echocardiogram were randomized in blinded fashion to receive 1,500 mg of L-carnitine daily for 3 months in comparison to a no treatment group (31 patients). Baseline echocardiographic and follow-up measurements of diastolic parameters were assessed after 3 months. Results: Important parameters of diastolic function improved in the L-carnitine group only: left atrial size (3.6 +/- 0.4 cm before treatment vs. 3.4 +/- 0.5 cm after treatment, p = 0.01); isovolemic relaxation time (127 +/- 26 ms before vs. 113 +/- 24 ms after treatment, p = 0.007); septal mitral E' velocity (0.064 +/- 0.01 m/s before vs. 0.074 +/- 0.01 m/s after treatment, p = 0.01), and lateral mitral E velocity (0.082 +/- 0.01 m/s before vs. 0.091 +/- 0.02 m/s after treatment, p = 0.006). Dyspnea also significantly improved in L-carnitine-treated patients.
In patients with a history of diastolic heart failure, important indices of diastolic function and symptoms appear to improve with L-carnitine treatment.
"In the present study, l-carnitine neutralized the ketamine-induced decrease in heart rate and returned the ketamine-induced decrease in activated ERK (P-ERK) levels back to normal, suggesting that l-carnitine may have altered cellular Ca 2+ transport in doing so, since palmitoyl carnitine is known to be an endogenous promoter of calcium efflux from rat heart mitochondria  and acylcarnitines increase calcium concentrations in the cytoplasm of rat ventricular cardiomyocytes . In patients with mild diastolic heart failure l-carnitine improves their symptoms . Differential effects of ketamine and l-carnitine are that ketamine induces a blockade of lipid oxidation and a decrease in ATP content in rat heart  whereas l-carnitine facilitates fatty-acid oxidation to support ATP production . "
[Show abstract][Hide abstract] ABSTRACT: Ketamine, an antagonist of the N-methyl-D-aspartate (NMDA)-type glutamate receptors, is a pediatric anesthetic. Ketamine has been shown to be neurotoxic and cardiotoxic in mammals. Here, we show that after 2 h of exposure, 5 mM ketamine significantly reduced heart rate in 26 h old zebrafish embryos. In 52 h old embryos, 1 mM ketamine was effective after 2 h and 0.5 mM ketamine at 20 h of exposure. Ketamine also induced significant reductions in activated MAPK (ERK) levels. Treatment of the embryos with the ERK inhibitor, PD 98059, also significantly reduced heart rate whereas the p38/SAPK inhibitor, SB203580, was ineffective. Ketamine is known to inhibit lipolysis and a decrease of ATP content in the heart. Co-treatment with l-carnitine that enhances fatty acid metabolism effectively rescued ketamine-induced attenuated heart rate and ERK activity. These findings demonstrate that l-carnitine counteracts ketamine's negative effects on heart rate and ERK activity in zebrafish embryos.
[Show abstract][Hide abstract] ABSTRACT: A method of iterative learning control system design based on the
two-dimensional (2D) theory is applied to the trajectory tracking
control problem for the parallel link robot manipulator designed at the
National Institute of Standards and Technology (NIST). The 2D model for
the iterative learning control system which reveals the connections
between learning control systems and 2D system theory, is established. A
novel learning control algorithm whose convergence is guaranteed by 2D
stability is proposed and applied successfully to the parallel-link
robot manipulator. The excellent performance of the learning algorithm
is demonstrated by computer simulation results
Intelligent Control, 1989. Proceedings., IEEE International Symposium on; 10/1989
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