L-carnitine in children with idiopathic dilated cardiomyopathy.

L-carnitine has been used in dilated cardiomyopathy secondary to carnitine deficiency in children, with favourable results. There are no reports on the effects of L-carnitine in children with idiopathic dilated cardiomyopathy. We undertook a prospective study to evaluate the effects of L-carnitine in children with idiopathic dilated cardiomyopathy. Thirteen children, mean age 3.29 +/- 1.44 years, with idiopathic dilated cardiomyopathy underwent echocardiographic evaluation while on conventional treatment alone, and with additional L-carnitine (50 mg/kg/day). To obviate the effects of spontaneous improvement, eight patients (Group 1) were restudied three weeks after stopping the drug, and five (Group 2) were restudied three weeks after addition of carnitine. Conventional treatment was continued throughout. After repeat echocardiographic examination, the parameters were compared statistically. With addition of carnitine, besides symptomatic improvement, the mean left ventricular ejection fraction improved from 36.9 +/- 16.1 percent to 46.9 +/- 14.5 percent (p < 0.001) and the mean pre-ejection period/left ventricular ejection time ratio from 39.07 +/- 14.8 to 43.2 +/- 8.1 (p < 0.01) in the entire group. These changes were concordant in both the subgroups. It was concluded that L-carnitine therapy in children with idiopathic dilated cardiomyopathy led to modest improvement in left ventricular function.