Effect of <smlcap>L</smlcap>-Carnitine Supplementation on Reverse Remodeling in Patients with Ischemic Heart Disease Undergoing Coronary Artery Bypass Grafting: A Randomized, Placebo-Controlled Trial

Abstract

During cardiac failure, cardiomyocytes have difficulty in using the substrates to produce energy. <smlcap>L</smlcap>-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 <smlcap>L</smlcap>-carnitine and increases the oxidative stress. This study demonstrates the effect of <smlcap>L</smlcap>-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 <smlcap>L</smlcap>-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 <smlcap>L</smlcap>-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. <smlcap>L</smlcap>-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 <smlcap>L</smlcap>-carnitine group may indicate a clinical benefit of <smlcap>L</smlcap>-carnitine supplementation.

l-carnitine: Nutrition, pathology, and health benefits

“… Improving glucose tolerance ( Ruggenenti et al, 2009 ) Randomized, Placebo-Controlled Trial 28 patients (26 [93.0 %] males) with a mean age ± SD of 58.1 ± 10.5 years 50 mg/kg/day oral dose of l -carnitine ↑left ventricle ejection fraction (p = 0.002) and 14.3 % (p = 0.006) and 3.3 % (p > 0.05). Did not demonstrate any additional benefit in reverse remodeling ( Da Silva Guimarães et al, 2017 ) Multi-institutional, randomized, exploratory trial Fifty-nine breast cancer patients IP (125 g) once daily for 21 days contains l -carnitine (50 mg) Changes in the worst level of fatigue, GFS, and current feeling of fatigue HADS, EORTC QLQ-C30, and EORTC QLQ-BR23 scores were not significantly different ( Iwase et al, 2016 ) …”

Serum Metabonomics Reveals Risk Factors in Different Periods of Cerebral Infarction in Humans

“…This is the first time that this result was found in the serum of different periods of the CI patients. L-carnitine is an essential nutrient for transporting fatty acids that are needed to produce energy ( da Silva Guimarães et al, 2017 ). L-carnitine also strengthens the effect of insulin on glycogen storage ( Adeva-Andany et al, 2017 ).…”

Role and Location of L-Carnitine in Cytoprotection and Correction of Metabolic Processes in Patients With Metabolic Syndrome

“…В течение последнего года опубликованы исследова-ния, свидетельствующие об эффективной кардиопротекции L-карнитином в кардиохирургии при коронарной ангио-пластике [49] и протезировании сердечных клапанов [50].…”