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European Heart Journal 1994 15(9):1267-1273;
Copyright © 1994 by the European Society of Cardiology.
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© 1994 The European Society of Cardiology

Efficacy of L-propionylcarnitine treatment in patients with left ventricular dysfunction

S. CAPONNETTO, C. CANALE, M. A. MASPERONE, V. TERRACCHINI, G. VALENTINI and C. BRUNELLI

Università degli Studi di Genova, Dipartimento di Medicina Interna, Cattedra di Cardiologia Genova, Italy

Received 2 July 1993; revised 6 May 1994; .

Correspondence: Giovanni Valentini, Via Achille Torelli, 36, 00137 Rome, Italy.

Abstract

The effect of L-propionylcarnitine on patients with left ventricular dysfunction (EF<45%) NYHA class II, symptomatic despite therapy with digitalis and diuretics was evaluated in a phase II parallel, double- blind, randomized, placebo-controlled study. Fifty patients (28 men and 22 women) aged 37–70 years received 1.5 g of L-propionylcarnitine or placebo on a random basis as oral treatment for 6 months.

At baseline, during a 7 day placebo run-in period, and during the 6-month treatment bicycle exercise test, M-B mode and Doppler echocardiography, and clinical evaluation (clinical score) were repeatedly performed. The analysis of variance for repeated measurements showed a statistically significant difference (P<0.01 ) in the mean value of exercise time between the treatments over the period of the study. There was a final increase of 0.36 min in the placebo group, 1.4 min in the treated group and a minor production of lactate during exercise in the treated group.

Left ventricular shortening fraction and left ventricular ejection fraction showed a significant increase in the L-propionylcarnitine group (respectively P<0.01 and P<0.0001) whereas no difference was apparent in the placebo group. Stroke volume index and cardiac index showed significant increments in the treated group (P<0.05) and systemic vascular resistance was lowered (P<0.05). No haemodynamic variations were observed in the placebo group, and the clinical score showed a significant improvement in the L-propionylcarnitine treated group.

In conclusion, L-propionylcarnitine treatment was shown to improve patient symptomatology and effort tolerance.

Key Words: L-propionylcarnitine • left ventricular dysfunction • bicycle exercise test • echocardiography


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