Effects of levocarnitine on cardiac function of hemodialysis patients

【Objectives】We evaluated the effects of levocarnitine on the cardiac function of dialysis patients. 【Subjects】Among our 192 patients on maintenance dialysis, 153 eligible patients met the entry criteria based on the results of a questionnaire. We investigated the oral group (113 patients) who requested internal use. 【Methods】The study was an interventional, non-randomized control study. Patients in the oral group received levocarnitine at a dose of 20 mg/kg/day (up to 1,200 mg/day) for 6 months. Echocardiographic parameters and NT-proBNP level as predictors of heart failure were measured at baseline and after 3 and 6 months. 【Results】In the oral group, there was no significant change in LVDd, LAD, and the ratio of diastolic function parameters E/A and E/e' at 3 and 6 months compared with those at baseline. However, significant improvements of EF and left ventricular structure (LVMI) were noted at 3 and 6 months compared with those at baseline. We performed a subgroup analysis in which the patients were divided into 2 groups with and without left ventricular hypertrophy (LVH). In the group with LVH, EF increased significantly from 58.0±6.5% at baseline to 61.0±6.9% at 3 months and 60.5±6.8% at 6 months, and LVMI decreased significantly from 132.2±20.9 g/m2 to 108.5±23.9 and 110.8±22.3 g/m2, respectively. In contrast, there was no significant improvement in EF and LVMI in the group without LVH. There was no significant change in NT-proBNP level in the oral group compared with that at baseline. 【Conclusion】 Levocarnitine showed favorable effects on the cardiac function of dialysis patients, as shown by improved EF and decreased LVMI. Subgroup analysis revealed that responders to levocarnitine were patients with LVH.