Efficacy of L-propionylcarnitine treatment in patients with left ventricular dysfunction.
The effect of L-propionylcarnitine on patients with left ventricular dysfunction (EF < 45%) NYHA class II, symptomatic despite therapy with digitalis and diuretics was evaluated in a phase II parallel, double-blind, randomized, placebo-controlled study. Fifty patients (28 men and 22 women) aged 37-70 years received 1.5 g of L-propionylcarnitine or placebo on a random basis as oral treatment for 6 months. At baseline, during a 7 day placebo run-in period, and during the 6-month treatment bicycle exercise test, M-B mode and Doppler echocardiography, and clinical evaluation (clinical score) were repeatedly performed. The analysis of variance for repeated measurements showed a statistically significant difference (P < 0.01) in the mean value of exercise time between the treatments over the period of the study. There was a final increase of 0.36 min in the placebo group, 1.4 min in the treated group and a minor production of lactate during exercise in the treated group. Left ventricular shortening fraction and left ventricular ejection fraction showed a significant increase in the L-propionylcarnitine group (respectively P < 0.01 and P < 0.0001) whereas no difference was apparent in the placebo group. Stroke volume index and cardiac index showed significant increments in the treated group (P < 0.05) and systemic vascular resistance was lowered (P < 0.05). No haemodynamic variations were observed in the placebo group, and the clinical score showed a significant improvement in the L-propionylcarnitine treated group. In conclusion, L-propionylcarnitine treatment was shown to improve patient symptomatology and effort tolerance.
Caponnetto
S
S
Università degli Studi di Genova, Dipartimento di Medicina Interna, Italy.
Canale
C
C
Masperone
M A
MA
Terracchini
V
V
Valentini
G
G
Brunelli
C
C
D000328:Adult; D000368:Aged; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D002331:Carnitine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004311:Double-Blind Method; D015150:Echocardiography, Doppler; D005080:Exercise Test; D005260:Female; D006801:Humans; D007773:Lactates / Q000097:blood; D019344:Lactic Acid; D008297:Male; D008875:Middle Aged; D011773:Pyruvates / Q000097:blood; D019289:Pyruvic Acid; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy*
D002316:Cardiotonic Agents; D007773:Lactates; D011773:Pyruvates; C003223:propionylcarnitine; D019344:Lactic Acid; D019289:Pyruvic Acid; D002331:Carnitine