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

Abstract

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.

Efficacy and Safety of L-Carnitine Treatment for Chronic Heart Failure: A Meta-Analysis of Randomized Controlled Trials

“…Four studies [ 12 , 13 , 21 , 26 ] did not report the method of randomization, whereas the others reported a randomization number sequence or adaptive minimization randomization scheme. There were three studies [ 13 , 17 , 26 ] using the blind method; blind methods of all the other studies are unclear. One study [ 21 ] had high performance bias for the reason that more than 20% of patients were lost to follow-up.…”

“…One study [ 21 ] had high performance bias for the reason that more than 20% of patients were lost to follow-up. Selective reporting was found in three studies [ 13 , 21 , 26 ] because they did not present the ITT analysis data. These studies had high performance bias and detection bias.…”

Effect of carnitine on patients with heart failure: an evidence-based case report

“…The 6minute walk test did not show significant difference between control and intervention (P = 0.14). 9 The study from Song X et al also showed that carnitine had positive effect on serum-BNP (P = 0.01) and NT-proBNP (P = 0.0003). Both BNP and NT-proBNP can act as prognostic factors in patients with heart failure or in patients with asymptomatic left ventricular dysfunction.…”

“…8 Even so, giving carnitine can be a nutritional therapy for patients with heart failure that can help improve heart function and the quality of life of patients. Jing et al 9 carried out a research by administering carnitine intravenously twice a day for seven days, in the form of 1 g of L-carnitine dissolved in 100mL of normal saline in patients with heart failure. The assessment was carried out on the NYHA class of patients.…”

Carnitine promotes recovery from oxidative stress and extends lifespan in C. elegans

“…In humans, several studies suggest that carnitine could improve mental health in older adults with mild cognitive impairment or Alzheimer’s disease [ 15 ]. Carnitine may also improve other age-associated diseases such as cardiovascular diseases [ 16 – 19 ], atherosclerosis [ 20 ], neurometabolic disorders [ 21 ] and diabetic symptoms [ 22 – 25 ]. In addition, carnitine has also been used in adjuvant therapy to treat conditions such ashemodialysis [ 26 ].…”