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). conclusion: l-carnitine is beneficial in the treatment of congestive cardiac failure. it is more effective in ischemic as compared to congestive cardiomyopathy.