Transient reduction of human left ventricular mass in carnitine depletion induced by antibiotics containing pivalic acid.
OBJECTIVE
To study the effect of induced carnitine depletion on myocardial structure and function.


METHODS
7 healthy adult volunteers given 1200 mg pivmecillinam per day for 7-8 weeks were studied by echocardiography before and after 7-8 weeks of treatment and a 15 months follow up after the treatment period.


METHODS
Teaching hospital.


METHODS
Carnitine concentration in serum, urine, and muscle and echocardiographic measurements.


RESULTS
After 7-8 weeks of treatment the median free serum carnitine concentration was reduced to 7% and the median total muscle carnitine concentration to 46% of the pretreatment levels. The median diastolic interventricular septum thickness decreased by 14% (mean 26%, P = 0.028) and the median left ventricular mass by 10% (mean 20%, P = 0.018). Fifteen months later these dimensions had increased but not completely returned to pretreatment values.


CONCLUSIONS
Extended treatment with pivalic acid containing antibiotics causes carnitine depletion which may lead to changes in cardiac structure.
Department of Paediatrics, Gothenburg University, Sweden.
K
K
Abrahamsson
M
M
Mellander
B O
BO
Eriksson
E
E
Holme
U
U
Jodal
A
A
Jönsson
S
S
Lindstedt
D000293:Adolescent; D000328:Adult; D000561:Amdinocillin Pivoxil / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D002331:Carnitine / Q000097:blood / Q000172:deficiency* / Q000652:urine; D004452:Echocardiography; D005260:Female; D006346:Heart Septum / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000737:chemistry / Q000378:metabolism / Q000473:pathology; D009206:Myocardium / Q000378:metabolism* / Q000473:pathology; D010421:Pentanoic Acids / Q000009:adverse effects*; D013997:Time Factors
D000900:Anti-Bacterial Agents; D010421:Pentanoic Acids; D000561:Amdinocillin Pivoxil; C005566:pivalic acid; D002331:Carnitine