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KRONİK HEMODİYALİZ HASTALARINDA L-KARNITIN' İN SOL VENTRİKÜL FONKSİYONLARINA ETKİSİ: 6 AYLIK TEDAVİ SONUÇLARI

TH E EFFECT OF L-CARNITINE ON LEFT VENTRICULAR FUNCTIONS IN CHRONIC HEMODIALYSIS PATIENTS: THE RESULTS OF SIX MONTHS TREATMENT

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Abstract (2. Language): 
L-carnitine (L-C) deficiency seen in chronic hemodialysis (HD) patients may contribute to heart failure and arrhythmias, through damaging the myocardial energy metabolism. In this study, the effect of L-C treatment on left ventricular (LV) functions was investigated in chronic HD patients. Seventeen chronic HD patients (8 male, 9 female, mean age 41.3 years, range 21-73 years) were studied. Each patient was given L-C 2g a day peroral for 6 months. LV systolic and diastolic functions at the beginning and at the end of the treatment were assessed using M-mode and 2 D Doppler echocardiography. Diastolic function parameters were improved significantly while LV systolic functions did not change at the end of the six months of L-C treatment. No side effect was observed during treatment. Our results suggest that six months L-C treatment did not cause any change in LV systolic functions, on the other hand, diastolic functions improved significantly. Further placebo controlled, long-term clinical studies are needed to assess if there is any L-C effect on cardiovascular morbidity and mortality.
Abstract (Original Language): 
Kronik hemodiyaliz (HD) hastalarında görülen L-karnitin (L-K) eksikliği, myokardın enerji metabolizmasını bozarak, kalp yetmezliği ve aritmilere katkıda bulunabilmektedir. Bu çalışmada, kronik HD hastalarında L-K tedavisinin sol ventrikülfonksiyonlarına etkisi incelenmiştir. Çalışmaya yaş ortalaması 41.3 yıl (21-73), 8i erkek 9'u kadın olan 17 kronik HD hastası alınmıştır. Hastalara 6 ay süre ile günde 2 gram oral L-K tedavisi uygulanmıştır. Tedavi öncesi ve sonrası sol ventrikül sistolik ve diyastolik fonksiyonları, M-mode ve 2 D Doppler ekokardiyogra.fi ile değerlendirilmiş¬tir. Altı aylık tedavi sonunda sol ventrikül sistolik fonksiyonlarında değişiklik olmaz iken diyastolik fonksiyon parametrelerinde anlamlı düzelmeler ol¬muştur. Tedavi süresince ilaca ait bir yan etki gözlen¬memiştir. Sonuçlarımız, kronik HD hastalarında 6 aylık L-K tedavisinin sol ventrikül sistolik fonksiyonlarını de¬ğiştirmediğini ancak diyastolik fonksiyonlarda önemli düzelmeler sağladığını ortaya koymaktadır. L-K tedavisinin kardiyovasküler morbidite ve mortalite üzerine etkisinin anlaşılabilmesi için plasebo kontrol¬lü uzun süreli klinik çalışmalara gereksinim vardır.
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