ROLE OF L-CARNITINE IN CONGESTIVE CARDIAC FAILURE

Objective: To determine the effect of L- Carnitine on functional and echocardiographic parameters of patients with congestive cardiac failure (CCF).Material and Methods: This double-blinded placebo control trial was conducted on 100 cases of CCF at cardiology outdoor department from March 2006 to May 2006. Subjects were randomized into group A (n=50) receiving 1 gm L-Carnitine and group B (n=50) receiving placebo. Baseline and at three months follow-up clinical and echocardiographic data of subjects was recorded.Results: In L-Carnitine vs. placebo, 6 minutes walk was 400 + 87 m vs. 360 + 85 m (p = 0.04), NYHA class II and III improved (p= 0.7, p=0.3 respectively), LVED dimension showed no significant improvement (5.8 +0.7 cm vs. 5.7 + 0.7 cm, p= 0.69), and FS improved (18.37 + 3.4 vs. 19.90 + 6.7, p= 0.03). The 6 minutes walk and FS improved in ischemic vs. Congestive cardiomyopathy (412 + 74 vs. 374 + 108 meters, p= 0.3), (19.2 + 50 % vs.15.9 + 3.6 %, p=0.03). In ischemic cardiomyopathy 6 minutes walk improved (p= 0.001), LVED dimension increased (p=0.24), FS improved (p= 0.50) and NYHA class II (p=0.001), and III (p=0.02) improved. In congestive cardiomyopathy 6 minutes walk improved from baseline (p=0.13), FS showed no improvement (p=0.23), LVED dimension was not affected significantly (p= 0.65). NYHA class improved (p=0.05).onclusion: L- carnitine is beneficial in the treatment of congestive cardiac failure. It is more effective in ischemic as compared to congestive cardiomyopathy.