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L-Carnitine Helps Reduce Death From Congestive Heart FailureSeptember 1999, Vol. V No.9 - Author: Dr. Sinatra While the number of heart attacks in the United States has dropped in the last 20 years (largely due to positive lifestyle changes) deaths from congestive heart failure (CHF) (an energy-starved heart) have more than doubled during the same period. Why? We don't really know why. But I believe it's because we're not giving people the nutritional support they need to feed their starving hearts. Currently, the typical treatment for CHF is: Digitalis (Lanoxin, Digoxin), which increases the strength of the heart's contractions and also helps slow the heart so it can fill and empty better. Diuretics (Lasix, Bumex, Aldactone, etc.), which help the body eliminate excess salt and water. Aldactone, which has been around for more than 30 years, has received a fair amount of news coverage recently because of its ability to preserve potassium and improve the survival rate of people with CHF. This low-cost diuretic should be used more often. Other commonly prescribed drugs are ACE inhibitors or beta-blockers, which relax arteries and lower blood pressure, thereby reducing stress on the heart and allowing it to pump more effectively. I've written much about both in the past (see HeartSense, March 1999, p.6). Unfortunately, these drugs are now given like aspirin for a headache. Yes, the pain is gone, but do we know what caused the headache so we can prevent another one from occurring? Certainly, it's wonderful to alleviate a patient's symptoms, but these remedies don't get to the heart of the problem. While many people feel better when they take these agents, their underlying heart problems rarely improve?and may even get worse. What's missing from the equation? Nutrients. Chief among them is L-carnitine. I've just finished doing a massive amount of research on L-carnitine for a book that I'm writing. I've found many studies that show how L-carnitine improves the survival rate of CHF patients. This is great news! This nutrient, like coenzyme Q10, is often lacking in CHF patients. It not only reduces or eliminates symptoms, but also fuels the "energy" houses of the heart's cells (the mitochondria) so the heart can pump better. This is what I call a total frontal attack of the problem! All of my CHF patients take L-carnitine in conjunction with conventional therapies. It has helped me lessen heart failure and keep many patients out of the hospital. In fact, it should come as no surprise, given that I'm a cardiologist, that I encourage 80% of my patient population to take L-carnitine. I'll never forget when I lost five patients in one week to CHF. That was in the early part of the decade, before I started using L-carnitine. Now that I employ it widely, I have much more hope for a better quality of life for my CHF patients, as well as an improved survival rate. Indeed, the high mortality rate for CHF patients is a major problem. Often these patients have so much scar tissue from multiple heart attacks that the amount of healthy, functioning muscle is limited. And that frequently sets these patients up for heart failure. There is absolutely no downside to L-carnitine, which is even more effective when coupled with CoQ10 (see HeartSense, March 1999, p.7). Let's take a look at the research. L-carnitine Reduces Mortality, Study Shows In one controlled study of 160 patients hospitalized for heart attack, 80 received 4 grams of L-carnitine daily for 12 months. The other half received placebos. Both groups, meanwhile, continued to take conventional drugs during the study. The upshot, blood pressure and cholesterol levels improved and rhythm disorders and CHF symptoms lessened or abated. The most significant finding was a tremendous reduction in mortality among those taking carnitine supplements: 1.2% compared to 12.5% for the controls. More recently, in a double-blind, placebo-controlled study, 100 patients with heart attack symptoms received 2 grams of L-carnitine a day for 28 days. Arrhythmia, angina, heart failure and muscle damage all improved. There also was a significant reduction in cardiac death and non-fatal heart attack in the L-carnitine group: 15.6% compared to 26% in the placebo group. Although a larger study is needed to confirm this research, the fact remains that L-carnitine improved arrhythmias, the rate of recurring heart attack and even death from heart attack. In a European study published in 1995 in the Journal of the American College of Cardiology, 472 patients received intravenous doses of 9 grams of carnitine a day for five days, followed by 6 grams daily (orally) for the next year. The incidence of CHF death was 6% in the L-carnitine group versus 9.6% in placebo group, a reduction of more than one third. Again, this data further confirms that L-carnitine prolongs life in these vulnerable patients. Researchers also validated previous studies by demonstrating an improvement in the heart's ejection fraction (EF) rate (the proportion of blood that's pumped out of the heart on each heartbeat. In CHF, the EF is often as low as 10-15%; a good rate is over 50%), as well as a reduction in the size of the left ventricle. The smaller the heart size, the better the survival rate. Cardiomyopathy Numerous studies also show that patients with cardiomyopathy, another common cardiac condition, have L-carnitine deficiencies. This condition (characterized by heart tissue that's damaged, diseased, scarred and a heart chamber that's enlarged, stretched or dilated) is often caused by a history of chronic high blood pressure or long-standing alcohol abuse, valve problems, viruses that attack the heart or even atherosclerosis. In animal studies, researchers concluded that an L-carnitine deficiency causes biochemical changes that impair the function of the heart. In the case of the Syrian hamster, researchers gave the rodent L-carnitine in the early stages of cardiomyopathy and successfully prevented further damage to the animal's heart. In a study of very young children with cardiomyopathy, researchers found that the children responded favorably to prolonged administration of L-carnitine. Given the research on L-carnitine, I wouldn't hesitate to give it to anyone, whether that person was having an acute heart attack or had a history of heart disease and/or CHF. L-carnitine is a must for anyone with any form of heart disease. It is also a great preventive as well as an anti-aging nutrient. I take L-carnitine myself and I plan to add it to my coenzyme Q10 Q-gel formula in the future (it's patented by Sigma-Tau.) Please stay tuned. References: Davini P, Bigalli A, Lamanna F, Boem A. "A controlled study on L-carnitine therapeutic efficacy in post-infarction," Drugs Exp Clin Res., 1992;18:355?365. Singh RB, Niaz MA, Agarwal P, et al. "A randomized, double-blind, placebo-controlled trial of L-carnitine in suspected acute myocardial infarction," Postgrad Med J, 1996;72:45?50. Iliceto S, Scrutinio D, Bruzzi P, et al. "Effects of L-carnitine administration on left ventricular remodeling after acute anterior myocardial infarction: the L-carnitine ecocardiografia digitalizzata infarto miocardioco (CEDIM) trial," JACC, 1995;26(2):380?7. Kobayashi A, Yoshinori M, Yamazaki N. "L-carnitine treatment for congestive heart failure: experimental and clinical study," Jpn Circ J, 1992;56:86?94. Bashore TM, Magorien DJ, Letterio J, et al. "Histologic and biochemical correlates of left ventricular chamber dynamics in man," J Mol Cell Cardiol, 1987;9:734. |
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