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Long-Term Levocarnitine Ameliorates Left Ventricular Diastolic as Well as Systolic Dysfunction in Hemodialysis

Junko Naito1, Hiroshige Ohashi2, Michiya Ohno2

  • 1Department of Cardiology, Gifu University Graduate School of Medicine Gifu Japan.

Circulation Reports
|March 11, 2021
PubMed

Insights

Levocarnitine supplementation improved both left ventricular (LV) diastolic and systolic dysfunction in hemodialysis (HD) patients. This treatment also reduced LV mass index and improved heart failure with preserved ejection fraction (HFpEF).

Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Hemodialysis (HD) patients often experience left ventricular (LV) systolic dysfunction and hypertrophy.
  • The impact of levocarnitine on LV diastolic dysfunction in HD patients remains unclear.
  • Heart failure with preserved ejection fraction (HFpEF) is a common comorbidity in HD patients.

Purpose of the Study:

  • To investigate the effect of levocarnitine on LV diastolic function in HD patients.
  • To evaluate levocarnitine's impact on LV systolic function and LV mass index.
  • To assess levocarnitine's efficacy in treating HFpEF in the HD population.

Main Methods:

  • Eighty-eight HD patients received intravenous levocarnitine (1,000 mg) for 12 months post-dialysis.
  • Echocardiography measured LV ejection fraction (EF), E/A, E/e', left atrial volume index (LAVI), and LV mass index (LVMI) at baseline and follow-up.
  • Plasma levels of brain natriuretic peptide, total carnitine, free carnitine, and acyl-carnitine were monitored.

Main Results:

  • Levocarnitine significantly improved LV diastolic function in patients with pre-existing diastolic dysfunction.
  • LV systolic function was enhanced in HD patients with systolic dysfunction.
  • Levocarnitine led to a significant decrease in LVMI and improved HFpEF, while increasing plasma carnitine levels.

Conclusions:

  • Levocarnitine effectively ameliorates both LV diastolic and systolic dysfunction in hemodialysis patients.
  • The treatment demonstrates benefits for LV mass reduction and HFpEF management in this cohort.
  • Levocarnitine supplementation is a promising therapeutic option for cardiovascular complications in HD patients.

Keywords:
HFpEFHemodialysisLV diastolic dysfunctionLV systolic dysfunctionLevocarnitine

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