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European Journal of Heart Failure 2000 2(2):189-193; doi:10.1016/S1388-9842(00)00064-7
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© 2000 European Society of Cardiology

The effects of L-carnitine treatment on left ventricular function and erythrocyte superoxide dismutase activity in patients with ischemic cardiomyopathy

Adalet Gürleka,*, Eralp Tutara, Ethem Akçilb, Irem Dinçera, Çetin Erola, Pelin A. Kocatürkb and Dervis Orala

a Department of Cardiology, Ankara University Faculty of Medicine Ankara, Turkey
b Department of Pathophysiology, Ankara University Faculty of Medicine Ankara, Turkey

* Corresponding author. Birlik Mahallesi 11.sokak 24/15, Çankaya, Ankara, Turkey. Tel.: +90-312-3103333; fax: +90-312-3125251.


   Abstract

We studied the effects of L-carnitine on left ventricular systolic function and the erythrocyte superoxide dismutase activity in 51 patients with ischemic cardiomyopathy. They all previously were under the treatment of angiotensin-converting enzyme inhibitor, digitalis and diuretics. Patients were randomized into two groups. In group I (n = 31), 2 g/day L-carnitine was added to therapy. L-Carnitine was not given to the other 20 patients (Group II). In group I (mean age 64.3 ± 7.8 years), 27 of the patients were men, and four were women. In group II (mean age 66.2 ± 8.7 years), 17 of the patients were men, and three were women. Twenty age-matched healthy subjects (mean age: 60.1 ± 5.3 years) constituted the control group. In each group, left ventricular ejection fraction (LVEF) by echocardiography and red cell superoxide dismutase activity by spectrophotometric method were measured initially and after 1 month of randomisation. Compared with normal healthy subjects (n = 20), patients (n = 51) had significantly higher red cell SOD activity (5633 ± 1225 vs. 3202 ± 373 U/g Hb, P < 0.001). At the end of 1 month of L-carnitine therapy, red cell SOD activity showed an increase in group I (5918 ± 1448 to 7218 ± 1917 U/g Hb, P < 0.05). In group II, red cell SOD activity showed no significant change after 1 month of randomisation (5190 ± 545 to 5234 ± 487 U/g Hb, P = 0.256). One month after randomisation there was a significant increase in LVEF in both groups I and II (37.8–42.3%, P < 0.001 in group I; 41.5–43.8%, P < 0.001 in group II). The improvement in LVEF was more significant in the L-carnitine group (4.5% vs. 2.3%, P < 0.01). We conclude that, as a sign of increased free radical production, superoxide dismutase activity was further increased in patients with L-carnitine treatment. L-Carnitine treatment in combination with other traditional pharmacological therapy might have an additive effect for the improvement of left ventricular function in ischemic cardiomyopathy.

Key Words: Ischemic cardiomyopathy • L-Carnitine • Erythrocyte superoxide dismutase

Received September 23, 1999; Revised January 17, 2000; Accepted February 16, 2000


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