Circulation, Vol 77, 767-773, Copyright © 1988 by American Heart Association
G Brevetti, M Chiariello, G Ferulano, A Policicchio, E Nevola, A Rossini, T Attisano, G Ambrosio, N Siliprandi and C Angelini
A double-blind, cross-over study was designed to evaluate the effects of
L-carnitine in patients with peripheral vascular disease. After drug
washout, 20 patients were randomly assigned to receive placebo or L-
carnitine (2 g bid, orally) for a period of 3 weeks and were then crossed
over to the other treatment for an additional 3 weeks. The effect on
walking distance at the end of each treatment period was measured by
treadmill test. Absolute walking distance rose from 174 +/- 63 m with
placebo to 306 +/- 122 m (p less than .01) with carnitine. Biopsy of the
ischemic muscle, carried out before and after 15 days of L-carnitine
administration in four additional patients, showed that treatment
significantly increased total carnitine levels. An additional goal of this
study was to ascertain the effects of L-carnitine on the metabolic changes
induced by exercise in the affected limb. In six patients under control
conditions, arterial and popliteal venous lactate and pyruvate
concentrations were determined at rest, when the maximal walking distance
was reached, and 5 min after the walking test. Twenty-four hours later,
L-carnitine was administered intravenously (3 g as a bolus followed by an
infusion of 2 mg/kg/min for 30 min) and metabolic assessments were
repeated. Five minutes after the walking test, popliteal venous lactate
concentration increased by 107 +/- 16% before treatment and by only 54 +/-
32% (p less than .01) after carnitine. Furthermore, carnitine induced a
more rapid recovery to the resting value of the lactate/pyruvate
ratio.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Increases in walking distance in patients with peripheral vascular disease treated with L-carnitine: a double-blind, cross-over study
Department of Medicine, Second Medical School, University of Naples, Italy.
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