title: Effects of intravenous l-carnitine on myocardial fatty acid imaging in hemodialysis patients: responders or non-responders to l-carnitine.
abstract: We investigated whether chronic intravenous administration of l-carnitine could improve myocardial fatty acid imaging in patients on maintenance hemodialysis. We enrolled 72 hemodialysis patients who had impaired myocardial fatty acid imaging and left ventricular dysfunction not based on coronary lesion. l-Carnitine (1,000 mg) was intravenously administered after dialysis for 1 year to 36 participants (Carnitine group), while not in the other 36 participants (Control group). Single-photon emission computed tomography (SPECT) using an iodinated fatty acid analogue, BMIPP, was performed. Uptake on SPECT images was graded in 17 segments on a five-point scale (0, normal; 4, absent) and assessed as BMIPP summed scores. During follow-up, 19 participants were discontinued from the study, and 53 participants (65 ± 12 years: 27 carnitine, 26 control) were analyzed. The mean BMIPP summed scores 1 year after carnitine administration did not differ from that before in the carnitine group, nor from that in the control group. However, improved SPECT (Changes in BMIPP summed scores <-20%) was found in 7 (25.9%) participants in the carnitine, whereas in 2 (7.7%) in the control group. Multivariate logistic analysis showed the improved SPECT was inversely associated with baseline serum albumin levels (1 g/L: odds ratio, 0.669); the cut-off was 35 g/L. Chronic intravenous l-carnitine might improve myocardial fatty acid imaging in a selected group of hemodialysis patients with hypoalbuminemia.
authors.affiliation: Cardiovascular Division, Toujinkai Hospital, 83-1, Iga, Momoyama-cho, Fushimi-ku, Kyoto, 612-8026 Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Nishimura
authors.affiliation: Department of Nephrology, Toujinkai Hospital, Kyoto, Japan.
authors.forename: Toshiko
authors.initials: T
authors.lastname: Tokoro
authors.affiliation: Department of Nephrology, Toujinkai Hospital, Kyoto, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Takatani
authors.affiliation: Department of Urology, Toujinkai Hospital, Kyoto, Japan.
authors.forename: Nodoka
authors.initials: N
authors.lastname: Sato
authors.affiliation: Department of Urology, Toujinkai Hospital, Kyoto, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Nishida
authors.affiliation: Department of Urology, Toujinkai Hospital, Kyoto, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Hashimoto
authors.affiliation: Department of Urology, Toujinkai Clinic, Kyoto, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Yamazaki
authors.affiliation: Department of Urology, Toujinkai Hospital, Kyoto, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kobayashi
authors.affiliation: Department of Urology, Toujinkai Hospital, Kyoto, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ono
keywords: Carnitine; Fatty acid; Heart; Hypoalbuminemia; Imaging; Uremic cardiomyopathy