Serati Ali Reza, Motamedi Mohammad Reza, Emami Sepideh, Varedi Peyman, Movahed Mohammad Reza
Cardiovascular Research Center, Modarres Hospital, Tehran, Iran.
Cardiology. 2010;116(3):178-82. doi: 10.1159/000318810. Epub 2010 Jul 16.
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.
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.
左旋肉碱是活化脂肪酸转运的关键成分。本研究旨在评估左旋肉碱对有轻度心力衰竭和舒张功能障碍病史患者的影响。
29例有纽约心脏协会（NYHA）II级功能症状且射血分数>45%、经超声心动图证实有1级舒张功能障碍的患者，与未治疗组（31例患者）进行盲法随机分组，接受每日1500毫克左旋肉碱治疗，为期3个月。3个月后评估舒张参数的基线超声心动图和随访测量值。
仅左旋肉碱组舒张功能的重要参数得到改善：左心房大小（治疗前3.6±0.4厘米 vs. 治疗后3.4±0.5厘米，p = 0.01）；等容舒张时间（治疗前127±26毫秒 vs. 治疗后113±24毫秒，p = 0.007）；室间隔二尖瓣E'速度（治疗前0.064±0.01米/秒 vs. 治疗后0.074±0.01米/秒，p = 0.01），以及二尖瓣外侧E速度（治疗前0.082±0.01米/秒 vs. 治疗后0.091±0.02米/秒，p = 0.006）。左旋肉碱治疗的患者呼吸困难也显著改善。
在有舒张性心力衰竭病史的患者中，左旋肉碱治疗似乎可改善舒张功能的重要指标和症状。
