title: Effect of L-carnitine on the physical fitness of thalassemic patients.
abstract: Poor physical fitness is a common problem among thalassemic patients. L-Carnitine plays an essential role in fatty acid beta-oxidation, a process especially important in the organs that preferentially use fatty acid as a source of energy such as the myocardium and the skeletal muscles. The main objective of this study is to assess the effect of the administration of oral L-carnitine on exercise tolerance and physical fitness in patients with thalassemia major. Thirty patients followed up at the New Cairo University Children Hospital were included in this study. Clinical, laboratory, and cardiopulmonary exercise testing were performed before and after 6 months of oral L-carnitine therapy (50 mg/kg/day). The oxygen consumption, cardiac output, and oxygen pulse at maximal exercise significantly increased after L-carnitine therapy (p<0.001, p=0.002 and p<0.001, respectively). However, there was no significant change in minute ventilation and ventilatory equivalent of carbon dioxide (p=0.07 and p=0.06, respectively). A weak but positive correlation between the age of the patients and the degree of improvement in exercise parameters was noted. There was also significant increase in the blood transfusion intervals after L-carnitine administration (p=0.008). However, there was no significant change in hemoglobin concentration (p=0.4). L-Carnitine seems to be a safe and effective adjunctive therapeutic approach in thalassemic patients. It improves their cardiac performance and physical fitness. The younger the patients are, the higher is the degree of improvement in their exercise parameters.
authors.affiliation: Department of Pediatrics, New Children Hospital, Cairo University, Cairo, Egypt.
authors.forename: Amal
authors.initials: A
authors.lastname: El-Beshlawy
authors.forename: Ramzi
authors.initials: R
authors.lastname: El Accaoui
authors.forename: Mansour
authors.initials: M
authors.lastname: Abd El-Sattar
authors.forename: Mohamed Hany
authors.initials: MH
authors.lastname: Gamal El-Deen
authors.forename: Ilham
authors.initials: I
authors.lastname: Youssry
authors.forename: Naglaa
authors.initials: N
authors.lastname: Shaheen
authors.forename: Mona
authors.initials: M
authors.lastname: Hamdy
authors.forename: Mona
authors.initials: M
authors.lastname: El-Ghamrawy
authors.forename: Ali
authors.initials: A
authors.lastname: Taher
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D001803:Blood Transfusion; D002331:Carnitine / Q000008:administration & dosage* / Q000494:pharmacology*; D002648:Child; D003131:Combined Modality Therapy; D017079:Exercise Tolerance / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D010101:Oxygen Consumption / Q000187:drug effects; D010809:Physical Fitness; D017086:beta-Thalassemia / Q000188:drug therapy*
chemical_list: D002331:Carnitine