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L-carnitine in children with idiopathic dilated cardiomyopathy
1Department of Cardiology, All India Institute of Medical Sciences, New Delhi.
Insights
L-carnitine supplementation modestly improved left ventricular function in children with idiopathic dilated cardiomyopathy. This study suggests potential benefits for pediatric idiopathic dilated cardiomyopathy patients receiving L-carnitine therapy.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Research
Background:
- Dilated cardiomyopathy (DCM) in children can stem from carnitine deficiency, where L-carnitine shows positive outcomes.
- Limited research exists on L-carnitine's efficacy in pediatric idiopathic dilated cardiomyopathy (IDCM).
Purpose of the Study:
- To prospectively evaluate the therapeutic effects of L-carnitine in children diagnosed with idiopathic dilated cardiomyopathy.
Main Methods:
- A prospective study involving thirteen pediatric patients with IDCM.
- Echocardiographic assessments were performed during conventional treatment alone and with added L-carnitine (50 mg/kg/day).
- Patients were divided into two groups to account for spontaneous improvement: eight patients stopped the drug temporarily, while five added it.
Main Results:
- L-carnitine addition significantly improved mean left ventricular ejection fraction from 36.9% to 46.9% (p < 0.001).
- The pre-ejection period/left ventricular ejection time ratio also showed significant improvement (p < 0.01).
- Symptomatic improvements were observed alongside enhanced echocardiographic parameters.
Conclusions:
- L-carnitine therapy demonstrates a modest but significant improvement in left ventricular function in pediatric patients with idiopathic dilated cardiomyopathy.
- Findings support L-carnitine as a potential adjunctive therapy for children suffering from IDCM.
Abstract:
L-carnitine has been used in dilated cardiomyopathy secondary to carnitine deficiency in children, with favourable results. There are no reports on the effects of L-carnitine in children with idiopathic dilated cardiomyopathy. We undertook a prospective study to evaluate the effects of L-carnitine in children with idiopathic dilated cardiomyopathy. Thirteen children, mean age 3.29 +/- 1.44 years, with idiopathic dilated cardiomyopathy underwent echocardiographic evaluation while on conventional treatment alone, and with additional L-carnitine (50 mg/kg/day). To obviate the effects of spontaneous improvement, eight patients (Group 1) were restudied three weeks after stopping the drug, and five (Group 2) were restudied three weeks after addition of carnitine. Conventional treatment was continued throughout. After repeat echocardiographic examination, the parameters were compared statistically. With addition of carnitine, besides symptomatic improvement, the mean left ventricular ejection fraction improved from 36.9 +/- 16.1 percent to 46.9 +/- 14.5 percent (p < 0.001) and the mean pre-ejection period/left ventricular ejection time ratio from 39.07 +/- 14.8 to 43.2 +/- 8.1 (p < 0.01) in the entire group. These changes were concordant in both the subgroups. It was concluded that L-carnitine therapy in children with idiopathic dilated cardiomyopathy led to modest improvement in left ventricular function.