Carnitine and left ventricular function in haemodialysis patients

Fagher, Birger; Cederblad, G.; Monti, Mario; Olsson, Lars; Rasmussen, Britt; Thysell, Hans

doi:10.3109/00365518509160995

Cited by 50 publications

(35 citation statements)

References 18 publications

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“…Only 1 randomized double-blind controlled study about the relationship of L -carnitine and cardiac function has been reported so far [18]. Fagher et al [18] reported in 1985 that carnitine depletion is not responsible for cardiac dysfunction in patients on hemodialysis, but their patients had normal levels of skeletal and blood carnitine.…”

Section: Discussionmentioning

confidence: 99%

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Hemodynamic Stabilizing Effects of <smlcap>L</smlcap>-Carnitine in Chronic Hemodialysis Patients

Kudoh¹,

Aoyama²,

Torii³

et al. 2013

Cardiorenal Med

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Background: The effects of L-carnitine on the hemodynamic state of chronic hemodialysis patients have been debated. In order to clarify the effect of administered L-carnitine on cardiac function and hypotensive episodes during the hemodialysis procedure, a randomized double-blind placebo-controlled study was performed for 3 months. Methods and Results: Twenty stable outpatients undergoing hemodialysis treatment were divided into two groups: controls (placebo) and treated patients (L-carnitine 900 mg p.o. daily). After 3 months, cardiac function was reevaluated by echocardiography, and hypotensive episodes during hemodialysis were assessed. Free and acyl carnitine levels increased significantly from 22.3 ± 7.1 to 140.3 ± 57.5 μmol/l and from 15.8 ± 2.8 to 94.8 ± 50.4 μmol/l, respectively, in the treated group. The ejection fraction significantly increased from 61.8 ± 16.0 to 64.4 ± 13.8% (p < 0.05) in the treated group. However, there was no difference in other echocardiographic parameters between the two groups. Hypotensive episodes significantly decreased from 4.0 ± 1.7 to 1.3 ± 0.9 times per month (p < 0.05), although patients' body weight did not change significantly. Conclusions: Beneficial effects of L-carnitine on the hemodynamic state of chronic hemodialysis patients were observed. L-Carnitine supplementation might be considered especially for chronic hemodialysis patients with unstable hemodynamic conditions.

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Section: Discussionmentioning

confidence: 99%

“…Some authors noted an improvement [13,14,15,16,17], while others found no change [18,19,20]. Firstly, study limitations such as heterogeneity of the study group, non-randomized, non-double-blind studies, and investigators' potential bias must be taken into account.…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic Stabilizing Effects of <smlcap>L</smlcap>-Carnitine in Chronic Hemodialysis Patients

Kudoh¹,

Aoyama²,

Torii³

et al. 2013

Cardiorenal Med

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“…[15][16][17]23,24 Our study was conducted in a larger study cohort and the result provide more robust support for LC supplementation in patients with CHF. However, although significant, the effect of LC over placebo was not impressive.…”

Section: Discussionmentioning

confidence: 99%

Effect of intravenous l-carnitine in Chinese patients with chronic heart failure

Jing

Peng

et al. 2016

Eur Heart J Suppl

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Chronic heart failure (CHF) may be associated with an energy deficit in cardiac muscle. As levo-carnitine (LC) is involved in the production of myocardial energy, it is hypothesized that LC supplementation may ameliorate CHF symptoms. This multicentre, randomized, double-blind, and placebo-controlled study included 265 patients with CHF. Patients were randomized to receive either LC or placebo, twice a day. Endpoints were measured after 7 days of treatment. Primary endpoint was a reduction of at least one NYHA class. Secondary endpoints were changes in 6-min walk distance (6-MWD) compared with baseline, either alone or in combination with NYHA class decrease, left ventricular ejection fraction, and NT-proBNP level, together with adverse events. The primary endpoint was reached in 60.9% of patients treated with LC, compared with only 44.7% of the placebo group (P ¼ 0.012). Among the secondary endpoints, 6-MWD, alone or in combination with NYHA class, improved significantly in the LC group compared with placebo (P ¼ 0.0497 and P ¼ 0.003, respectively). values of plasma-free carnitine were observed in patients with NYHA classes III and IV where the effect of LC supplementation was greatest (P ¼ 0.002). Treatment with LC significantly improved CHF symptoms in Chinese patients, probably by correcting a status of carnitine insufficiency.

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“…11 There were also reports of improvement of cardiac dysfunction by L-carnitine supplementation, especially in patients with declined cardiac systolic function or with symptoms of heart failure; [12][13][14][15] however, when patients with normal myocardial function were studied, no benefit of carnitine was seen. 13,16 Left ventricular hypertrophy (LVH) is common and is an independent predictor of cardiac death in patients undergoing dialysis. 17 In these conditions, falls in the contraction index value are not seen or are mild, but there is expansion of the ventricular cavity and increased myocardial thickness and heart weight.…”

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confidence: 99%

L-Carnitine Supplementation Decreases the Left Ventricular Mass in Patients Undergoing Hemodialysis

Sakurabayashi

Miyazaki

Yuasa

et al. 2008

Circ J

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Background Patients on long-term hemodialysis become deficient in carnitine and are frequently treated with carnitine supplementation to offset their renal anemia, lipid abnormality and cardiac dysfunction. The therapeutic value of carnitine supplementation on left ventricular hypertrophy (LVH) in patients with normal cardiac systolic function remains uncertain. Methods and ResultsThe cardiac morphology and function of 10 patients given 10 mg/kg of L-carnitine orally, immediately after hemodialysis sessions 3 times per week for a 12-month period were compared with 10 untreated control patients. Using echocardiography, left ventricular fractional shortening (LVFS) and left ventricular mass index (LVMI) were measured before and after the study period. As a result, amounts of serum-free carnitine increased from 28.4±4.7 to 58.5±12.1 mol/L. The LVMI decreased significantly from 151.8±21.2 to 134.0±16.0 g/m 2 in treated patients (p<0.01), yet the LVMI in untreated control patients did not change significantly (ie, from 153.3±28.2 to 167.1±43.1 g/m 2 ). However, LVFS values remained unchanged in both groups. Although L-carnitine promoted a 31% reduction in erythropoietin requirements, hematocrit and blood pressure did not change during the study period. Conclusions Supplementation with L-carnitine induced regression of LVH in patients on hemodialysis, even for those with normal systolic function. (Circ J 2008; 72: 926 -931)

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Carnitine and left ventricular function in haemodialysis patients

Cited by 50 publications

References 18 publications

Hemodynamic Stabilizing Effects of <smlcap>L</smlcap>-Carnitine in Chronic Hemodialysis Patients

Hemodynamic Stabilizing Effects of <smlcap>L</smlcap>-Carnitine in Chronic Hemodialysis Patients

Effect of intravenous l-carnitine in Chinese patients with chronic heart failure

L-Carnitine Supplementation Decreases the Left Ventricular Mass in Patients Undergoing Hemodialysis

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