Effects of Oral Amino Acid Supplements on Cardiac Function and Remodeling in Patients with Type 2 Diabetes with Mild-to-Moderate Left Ventricular Dysfunction

Abstract

The aim of this study was to evaluate the effects of an oral special mixture of amino acid (AA) supplements alongside angiotensin-converting enzyme (ACE) inhibitor therapy on left ventricular (LV) function and symptoms in patients with type 2 diabetes mellitus with mild-to-moderate LV dysfunction. It is established that the remodeling process is associated with late onset of heart failure and decreased survival. ACE inhibitor therapy reduces progressive increases in LV dimensions and significantly improves the clinical course of a broad spectrum of patients with LV dysfunction. Moreover, AA supplements prevent myocardial dysfunction caused by exercise in patients with type 2 diabetes. In addition to ACE inhibitor therapy, patients with diabetes were randomly assigned to receive AA supplements or placebo. LV function and dimensions were assessed with quantitative echocardiographic tests at intake into the study and after 6 months of follow-up. In patients with type 2 diabetes, LV end-diastolic index was reduced significantly during the 6-month period of AA consumption (89 +/- 9 mL/m2 vs 76 +/- 8 mL/m2; p <0.01), and LV ejection fraction (LVEF) improved (0.46 +/- 0.07 vs 0.52 +/- 0.05; p <0.001). No significant changes in LVEF or LV end-diastolic index occurred in the placebo group. These findings suggest that AA supplementation, together with ACE-inhibitor therapy, may have a beneficial effect on the LV remodeling process in patients with type 2 diabetes with mild-to-moderate LV dysfunction.