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Hemodynamic study of intravenous propionyl-L-carnitine in patients with ischemic heart disease and normal left
A Chiddo1, A Gaglione, S Musci
1Division of Cardiology, University of Bari, Italy.
Insights
Propionyl-L-carnitine improved cardiac function in patients with ischemic heart disease by reducing vascular resistance and enhancing heart efficiency. This suggests a potential positive inotropic effect, aiding heart muscle contraction.
Area of Science:
- Cardiology
- Pharmacology
- Physiology
Background:
- Chronic ischemic heart disease (IHD) affects cardiac function.
- Assessing interventions to improve ventricular performance in IHD is crucial.
Purpose of the Study:
- To evaluate the effects of propionyl-L-carnitine on cardiac function in patients with IHD.
- To determine if propionyl-L-carnitine improves ventricular performance and efficiency.
Main Methods:
- Intravenous administration of propionyl-L-carnitine (15 mg/kg) to ten IHD patients.
- Evaluation of pulmonary and systemic circulation, left ventricular function, and ventricle-afterload relationship.
Main Results:
- Propionyl-L-carnitine improved ventricular function by reducing cardiac load and enhancing efficiency.
- Decreased systemic and pulmonary resistance and increased arterial compliance led to increased stroke volume.
- Arterial pressure was maintained, with improved ventricle-afterload matching and enhanced cardiac efficiency.
Conclusions:
- Propionyl-L-carnitine demonstrates a beneficial effect on cardiac function in IHD patients.
- The drug may possess positive inotropic properties, warranting further investigation.
Abstract:
Propionyl-L-carnitine was given intravenously to ten patients with chronic ischemic heart disease who had normal left ventricular function and had not had a previous myocardial infarction. Subsequently, pulmonary and systemic circulation, left ventricular function, and the relationship between the ventricle and afterload were evaluated. This drug, at a dose of 15 mg/kg, improves ventricular function by easing the load and by enhancing cardiac efficiency. The ejection impedance is reduced with a consequent increase in stroke volume as a result of a) a decrease in systemic and pulmonary resistance and b) an increase in arterial compliance. Arterial pressure is maintained due to an increase in total external heart power. Since the tension time index shows a proportionally smaller increase in the energy requirement, it follows that cardiac efficiency has been improved and ventricle-afterload matching is optimal. These results suggest but do not prove that propionyl-L-carnitine exhibits a positive inotropic property.