Abstract
Coronary artery bypass grafting reduces plasma L-carnitine and may impair the production of myocardial energy. L-carnitine supplementation may elevate plasma L-carnitine and increase cardiac mechanical efficiency. The objective of this study was to verify the recovery of preoperative plasma LC in patients with heart failure undergoing coronary artery bypass grafting supplemented with a daily oral dose of 50 mg / kg. Volunteers with ischemic heart failure who underwent surgery were randomized into a supplemented group (A-received 50 mg / kg L-carnitine) or placebo group (B) for 60 days. Supplementation was started on the third postoperative day. The spectrophotometric enzymatic method was used to quantify plasma L-carnitine. In the preoperative period, both groups had plasma L-carnitine adequate to the reference range (18.9-71.1 μM). On the second postoperative day, there was a reduction in plasma L-carnitine in groups A (17.4%) and B (14.4%). In the comparison between the groups, plasma L-carnitine was higher in group A than B in 10º (p = 0.024), 30º (p = 0.001), and 60º postoperative day (p = 0.008). Supplementation of L-carnitine at a daily oral dose of 50 mg / kg in patients with heart failure undergoing coronary artery bypass grafting may recover preoperative plasma L-carnitine within 10 days.
Highlights
Of all the human organs, the heart has the greatest expenditure of energy at rest, and has a high demand for energy to sustain its workload
The objective of this study was to verify the recovery of preoperative plasma LC in patients with heart failure submitted to coronary artery bypass grafting supplemented with daily oral dose of 50 mg / kg
Volunteers with ischemic heart failure indicated for myocardial revascularization surgery were recruited at the National Institute of Cardiology / RJ between July 2012 and March 2014
Summary
Of all the human organs, the heart has the greatest expenditure of energy at rest, and has a high demand for energy to sustain its workload. With an adequate supply of oxygen, the heart preferably uses betaoxidation of fatty acids (FA) to generate energy. In a single study published by Da Silva Guimarães et al (2013), the authors showed that plasma LC was reduced after surgical revascularization. Low plasma LC can facilitate oxidative stress and, reduce energy production, compromising mechanical efficiency of the heart (Dantas et al 2015). Despite the numerous clinical studies showing the benefit of supplementation in ischemic HF (Dinicolantonio et al 2013, Soukoulis et al 2009) there is still no recommendation of dosage and time of administration. The objective of this study was to verify the recovery of preoperative plasma LC in patients with heart failure submitted to coronary artery bypass grafting supplemented with daily oral dose of 50 mg / kg
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