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Carnitine and peripheral arterial disease.

William R Hiatt1

  • 1University of Colorado Health Sciences Center, Colorado Prevention Center, Denver, CO 80203, USA. will.hiatt@uchsc.edu

Annals of the New York Academy of Sciences
|December 14, 2004
PubMed
Summary

Peripheral arterial disease (PAD) causes claudication, limiting exercise and daily life. Propionyl-L-carnitine improved walking distance and quality of life in patients with PAD, suggesting a benefit for skeletal muscle metabolism.

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Area of Science:

  • Cardiovascular Medicine
  • Metabolic Disorders
  • Exercise Physiology

Background:

  • Peripheral arterial disease (PAD) significantly impairs exercise capacity and daily functioning in symptomatic patients with claudication.
  • Claudication is characterized by reduced peak oxygen consumption and difficulty walking, impacting quality of life.
  • Skeletal muscle metabolic abnormalities, including impaired mitochondrial function and acylcarnitine accumulation, contribute to PAD pathophysiology.

Purpose of the Study:

  • To investigate the efficacy of L-carnitine and propionyl-L-carnitine in improving skeletal muscle metabolism and exercise performance in patients with PAD.
  • To evaluate the impact of propionyl-L-carnitine on treadmill walking distance, functional capacity, and quality of life in PAD patients.

Main Methods:

  • Two multicenter trials involving 730 patients with PAD and claudication were conducted.
  • Patients were treated with propionyl-L-carnitine or placebo.
  • Treadmill exercise testing was used to measure initial and maximal walking distances.

Main Results:

  • Propionyl-L-carnitine significantly improved both initial and maximal treadmill walking distances compared to placebo.
  • L-carnitine showed some improvement in treadmill performance, but propionyl-L-carnitine was more effective.
  • Patients receiving propionyl-L-carnitine reported improvements in quality of life and experienced minimal side effects.

Conclusions:

  • Propionyl-L-carnitine demonstrates efficacy in improving exercise performance and quality of life for patients suffering from claudication due to PAD.
  • The findings suggest that propionyl-L-carnitine can positively modulate skeletal muscle metabolism in ischemic conditions.
  • Further research may explore the therapeutic potential of propionyl-L-carnitine for PAD management, although it is not yet approved in the US.

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