الفهرس 
CARDIOMYOPATHIESOnly 14 pages are availabe for public view
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Abstract
The aim of this study was to estimate the L-Carnitine levels in dilated cardiomyopathic patients on conventional treatment for heart failure both pre and post L-carnitine therapy and to study the effect of L-carnitine as an adjuvant therapy for these patients on clinical status and echocardiographic parameters.
This study was conducted in the Pediatric Cardiology Clinic, Ain Shams and Abo- El-Rish Pediatric hospital. It included: Fourteen patients with dilated cardiomyopathy (7 males and 7 females) on conventional treatment for heart failure (namely digitalis, diuretics and ACE inhibitors), their age ranged between 5 and 84 ms with mean age of (43.64±24.06) ms.
All patients included in the study were subjected to full medical history, thorough clinical examination and classification according to (NYHA) functional classification, plain chest x ray PA view, electrocardiogram, echocardiography and measurement of serum carnitine level were done to all patients at the beginning of the study and repeated three months after L-carnitine therapy.
We observed that significant improvement occurred in the clinical status and effort tolerance of our patients (p> 0.01). Symptoms of congestive heart failure also decreased in the studied cases after carnitine therapy as anorexia (P> 0.01), abdominal pain or distension (P> 0.01) and recurrent wheezy chest (P> 0.01).
Serum carnitine level showed a significant increase and also improvement of systolic functions as assessed by EF and FS occurred after addition of L-carnitine to the conventional therapy.
Moreover reduction of the LV dimensions (LVEDD and LVESD) were observed (P >0.05, P >0.01 respectively) reflecting decrease in left ventricular size.
After therapy serum carnitine level correlated significantly with the fractional shortening, ejection fraction and body weight of our patients. But no other significant correlation could be detected between serum carnitine and other findings.
L-carnitine may be an effective drug in improving the general cardiac symptoms and increasing exercise capacity of dilated cardiomyopathic patients.
We thus conclude that propionyl-L- carnitine may impove cardiac systolic function, increase LVEF, FS and reduce ventricular size in patients with congestive heart failure on conventional therapy.
Hence L-carnitine can be added to the standard treatment of patients with dilated cardiomyopathy aiming at an additional improvement of cardiac symptoms and functions