Article

L-Carnitine Treatment in Patients with Mild Diastolic Heart Failure Is Associated with Improvement in Diastolic Function and Symptoms

Cardiovascular Research Center, Modarres Hospital, Tehran, Iran.
Cardiology (Impact Factor: 2.04). 07/2010; 116(3):178-82. DOI: 10.1159/000318810
Source: PubMed

ABSTRACT 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.

0 Followers
 · 
127 Views
  • Source
    • "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 [63] and acylcarnitines increase calcium concentrations in the cytoplasm of rat ventricular cardiomyocytes [64]. In patients with mild diastolic heart failure l-carnitine improves their symptoms [65]. 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 [45] whereas l-carnitine facilitates fatty-acid oxidation to support ATP production [62]. "
    [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.
    Reproductive Toxicology 10/2011; 33(2):205-12. DOI:10.1016/j.reprotox.2011.10.004 · 2.77 Impact Factor
  • [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
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Congest Heart Fail. 2011;17:199–203. © 2011 Wiley Periodicals, Inc. Heart failure (HF) is a growing epidemic worldwide with a particularly large presence in the United States. Nutritional assessment and supplementation is an area that can be studied to potentially improve the outcomes of these chronically ill patients. There have been many studies reporting the effect of various nutrients on HF patients, often with mixed results. Amino acids such as taurine, which is involved in calcium exchange, has been reported to improve heart function. Coenzyme Q10, a key component in the electron transport chain, is vital for energy production. l-carnitine, an amino acid derivative, is responsible for transport of fatty acids into the mitochondria along with modulating glucose metabolism. Thiamine and the other B vitamins, which serve as vital cofactors, can often be deficient in HF patients. Omega-3 fatty acid supplementation has been demonstrated to benefit HF patients potentially through anti-arrhythmic and anti-inflammatory mechanisms. Vitamin D supplementation can potentially benefit HF patients by way of modulating the renin-angiotensin system, smooth muscle proliferation, inflammation, and calcium homeostasis. Although supplementation of all of the above nutrients has the potential to benefit patients with HF, more studies are needed to solidify these recommendations. Congest Heart Fail.
    Congestive Heart Failure 07/2011; 17(4):199-203. DOI:10.1111/j.1751-7133.2011.00239.x
Show more