L-Carnitine Treatment in Patients with Mild Diastolic Heart Failure Is Associated with Improvement in Diastolic Function and Symptoms – Source: Cardiology, Jul 16, 2010

[Note: Heart failure is when the heart is unable to pump enough blood for all the body’s needs. Diastolic heart failure (DHF) affects the first phase of the heart’s pumping cycle – the diastole or relaxation phase, which is followed by the systole, or contracting phase. With DHF, the heart’s lower chambers become stiff and can’t fully relax/expand, so don’t fill properly with blood. With mild DHF, one generally experiences shortness of breath but only during activity or stress.]

Objectives: 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. [L-Carnitine, so named because it was first isolated from meat (carne), transports fatty acids into the mitochondria where they are ‘burned’ to release energy, and is the primary source of energy for the heart and other muscles.]

Methods: Twenty-nine patients with a history of NYHA functional class II symptoms and ejection fraction greater than 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 [shortness of breath] also significantly improved in L-carnitine-treated patients.

Conclusion: In patients with a history of diastolic heart failure, important indices of diastolic function and symptoms appear to improve with L-carnitine treatment.

Source: Cardiology, Jul 16, 2010. PMID: 20639632, by Serati AR, Motamedi MR, Emami S, Varedi P, Movahed MR. Cardiovascular Research Center, Modarres Hospital, Tehran, Iran.

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