L-carnitine treatment in patients with mild diastolic heart failure is associated with improvement in diastolic function and symptoms

Objectives: L-Carnitine is a crucial component of activated fatty acid transport. The aim of this study was to evaluate the effect of L-carnitine on patients with a history of mild heart failure and diastolic dysfunction. Methods: Twenty-nine patients with a history of NYHA functional class II symptoms and ejection fraction >45% with documented grade 1 diastolic dysfunction on echocardiogram were randomized in blinded fashion to receive 1,500 mg of L-carnitine daily for 3 months in comparison to a no treatment group (31 patients). Baseline echocardiographic and follow-up measurements of diastolic parameters were assessed after 3 months. Results: Important parameters of diastolic function improved in the L-carnitine group only: left atrial size (3.6 ± 0.4 cm before treatment vs. 3.4 ± 0.5 cm after treatment, p = 0.01); isovolemic relaxation time (127 ± 26 ms before vs. 113 ± 24 ms after treatment, p = 0.007); septal mitral E' velocity (0.064 ± 0.01 m/s before vs. 0.074 ± 0.01 m/s after treatment, p = 0.01), and lateral mitral E velocity (0.082 ± 0.01 m/s before vs. 0.091 ± 0.02 m/s after treatment, p = 0.006). Dyspnea also significantly improved in L-carnitine-treated patients. Conclusion: In patients with a history of diastolic heart failure, important indices of diastolic function and symptoms appear to improve with L-carnitine treatment.