2015


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2015/№4

Effect of L-carnitinee on echocardiographic parameters in patients with acute coronary syndrome

Glezer M. G., Kiseleva A. E., Prokofieva E. B., Astashkin E. I.
State Budgetary Educational Institution “I. M. Sechenov First Moscow State Medical University” of the RF Ministry of Health Care, Trubetskaya 8, Bldg. 2, Moscow 119991

Keywords: ACS, myocardial infarction, doppler tissue echocardiography, L-carnitine, left ventricular ejection fraction, local and global contractility, diastolic function

DOI: 10.18087 / rhfj.2015.4.2153

Background. High prevalence of HF is often due to myocardial injury in ACS and postinfarction heart remodeling. Therefore, searching for ways to reduce severity of myocardial damage and postinfarction remodeling is important. Aim. To evaluate the effect of intravenous L-carnitine injection on the structural and functional condition of the heart in patients with ACS. Materials and methods. The effect of intravenous L-carnitine/placebo injection on parameters of structural and functional heart condition was studied in 58 patients with ACS during the hospital period. EchoCG parameters were studied at 1-3 days and 12-15 days of admission. Results. The L-carnitine treatment resulted in decreases of end-systolic and end-diastolic volumes (ESV and EDV) of the heart, thereby improving LV myocardial contractility, whereas the placebo treatment resulted in a less pronounced decrease in ESV and a considerable increase in EDV. The most pronounced EF changes and a significant EF response to the L-carnitine treatment were observed in patients with originally reduced EF. In the L-carnitine treatment group, tissue dopplerography showed a significant increase in peak systolic velocity of myocardial motions in different LV segments. Thus, the peak systolic velocity (Sm) of basal and medium interventricular septal (IVS) segments increased from 3.5±1.3 to 4.1±1.2 m / sec (р<0.002) and from 2.7±1.2 to 3.2±1.2 m / sec (р<0.004), respectively. Basal, medium and apical lateral wall segment Sm increased from 3.6±1.7 to 4.3±1.8 m / sec (р<0.0008), from 2.5±1.3 to 2.9±1.2 m / sec (р<0.01), and from 1.7±0.9 to 2.0±0.8 m / sec (р<0.01), respectively. Basal and medium inferior wall segment Sm also increased from 3.1±1.4 to 3.6±1.2 m/sec (р <0.006) and from 2.6±1.1 to 2.7±0.4 m/sec, respectively. No significant increases in Sm of studied LV myocardial segments were observed in the standard treatment group and in the placebo group. Conclusion. Early post-ACS intravenous L-carnitine administration reduced the pronouncement of postinfarction heart remodeling and improved parameters of myocardial contractility during hospitalization. The most pronounced response was observed in patients with reduced baseline EF.
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Glezer M. G., Kiseleva A. E., Prokofieva E. B., Astashkin E. I. Effect of L-carnitinee on echocardiographic parameters in patients with acute coronary syndrome. Russian Heart Failure Journal. 2015;16 (4):234–240

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