The Effect of Carnitine Supplementation on Left Ventricular Function: Lessons from Current Evidence and Insights for Future Studies

Abstract

Introduction: In children, data on the effects on carnitine supplementation and myocardial function are limited. A few studies have investigated the relationship between serum carnitine levels in the setting of depressed cardiac function and have demonstrated possible benefits. As such, this systematic review and meta-analyses aimed to assess the effects carnitine supplementation on left ventricular function. Materials and Methods: A systematic review of the literature was performed to identify full text manuscripts in English. PubMed, EMBASE, and the Cochrane databases were queried. Studies were included with data from pediatric patients, that used carnitine supplementation and included preand post-carnitine data for at least one of the outcomes of interest. Results: A total of six studies including 144 patients were included. Carnitine dosage ranged from 50 to 100 mg/kg/day. The average duration of carnitine therapy was 9.8 months. Left ventricular ejection fraction was higher after carnitine supplementation with a mean difference between groups of 3.56 [95% confidence interval 0.06–7.06, p-value 0.04]. Left ventricular shortening fraction was higher after carnitine supplementation with a mean difference between groups of 3.68 [95% confidence interval 1.22–6.15, p-value 0.01]. Left ventricular end diastolic diameter was higher after carnitine supplementation, but the difference did not reach significance. Conclusion: Carnitine supplementation may augment left ventricular ejection fraction and shortening fraction. Those with lower baseline ejection fraction and shortening fraction appear to benefit the most from carnitine supplementation. Additional studies of the effects of carnitine on cardiac function are warranted.