Effect of L-Carnitine Supplementation on Reverse Remodeling in Patients with Ischemic Heart Disease Undergoing Coronary Artery Bypass Grafting: A Randomized, Placebo-Controlled Trial.
During cardiac failure, cardiomyocytes have difficulty in using the substrates to produce energy. L-carnitine is a necessary nutrient for the transport of fatty acids that are required for generating energy. Coronary artery graft surgery reduces the plasma levels of L-carnitine and increases the oxidative stress. This study demonstrates the effect of L-carnitine supplementation on the reverse remodeling of patients undergoing coronary artery bypass graft. Patients with ischemic heart failure who underwent coronary graft surgery were randomized to group A - supplemented with L-carnitine or group B controls. Left ventricular ejection fraction, left ventricular systolic and diastolic diameters were assessed preoperatively, 60 and 180 days after surgery. Our study included 28 patients (26 [93.0%] males) with a mean age ± SD of 58.1 ± 10.5 years. The parameters for the evaluation of reverse remodeling did not improve after 60 and 180 days of coronary artery bypass grafting in comparison between groups (p > 0.05). Evaluation within the L-carnitine group showed a 37.1% increase in left ventricle ejection fraction (p = 0.002) and 14.3% (p = 0.006) and 3.3% (p > 0.05) reduction in systolic and diastolic diameters, respectively. L-carnitine supplementation at a dose of 50 mg/kg combined with artery bypass surgery did not demonstrate any additional benefit in reverse remodeling. However, evaluation within the L-carnitine group may indicate a clinical benefit of L-carnitine supplementation.
Experimental Nutrition Laboratory, College of Nutrition Fluminense Federal University, Rio de Janeiro, Brazil.
Sheila
S
da Silva Guimarães
Wanise
W
de Souza Cruz
Licinio
L
da Silva
Gabrielle
G
Maciel
Ana Beatriz
AB
Huguenin
Monicque
M
de Carvalho
Bárbara
B
Costa
Geisiane
G
da Silva
Carlos
C
da Costa
João Alvaro
JA
D'Ippolito
Alexandre
A
Colafranceschi
Fernanda
F
Scalco
Gilson
G
Boaventura
D000368:Aged; D015992:Body Mass Index; D002331:Carnitine / Q000008:administration & dosage* / Q000097:blood; D001026:Coronary Artery Bypass; D019587:Dietary Supplements; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000188:drug therapy*; D011300:Preoperative Care; D057185:Sedentary Behavior; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects; D020257:Ventricular Remodeling
D002331:Carnitine
<span style="font-variant:small-caps; text-transform:lowercase">L</span>-Carnitine; Coronary artery bypass graft; Ischemic heart failure; Supplementation