117,476 research outputs found

    SUPERIORITY OF L-PROPIONYLCARNITINE VS L-CARNITINE IN IMPROVING WALKING CAPACITY IN PATIENTS WITH PERIPHERAL VASCULAR-DISEASE - AN ACUTE, INTRAVENOUS, DOUBLE-BLIND, CROSS-OVER STUDY

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    The effects of L-propionylcarnitine on walking capacity were assessed in a group of patients with peripheral vascular disease. In 12 patients, 300 mg of L-propionylcarnitine, given intravenously as a single bolus did not affect walking capacity, while 600 mg increased both initial claudication distance from the placebo value of 179 +/- 114 to 245 +/- 129 m (P less than 0.05), and maximal walking distance from 245 +/- 124 to 349 +/- 155 m (P less than 0.05). Once the efficacious dose of L-propionylcarnitine was assessed, its effect was compared to that of an equimolar dose of L-carnitine (500 mg i.v.) according to a double-blind, double-dummy, cross-over design. In 14 patients, both treatments improved walking capacity; however, the analysis of variance showed that the increase in maximal walking distance with L-propionylcarnitine was greater than that with L-carnitine (P less than 0.05). Finally, in seven additional patients, the effects of L-propionylcarnitine and L-carnitine on the haemodynamics of the affected limb were assessed by an ultrasonic duplex system. Results indicated that both drugs did not affect the blood velocity and the blood flow rate in the ischaemic leg, thus suggesting that the beneficial effect on walking capacity was dependent on a metabolic effect. In conclusion, L-propionylcarnitine improves walking capacity in patients with peripheral vascular disease, probably acting through a metabolic mechanism. On a molar basis, this beneficial effect is greater than that observed with L-carnitine and, thus, the findings of the present study may have clinical relevance in terms of treatment cost and patient complianc

    COMPARISON BETWEEN THE EFFECT OF L-PROPIONYLCARNITINE, L-ACETYLCARNITINE AND NITROGLYCERIN IN CHRONIC PERIPHERAL ARTERIAL-DISEASE - A HEMODYNAMIC DOUBLE-BLIND ECHO-DOPPLER STUDY

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    The haemodynamic effects on the peripheral vascular bed of L-acetylcarnitine, L-propionylcarnitine, and nitroglycerin were tested by echo-Doppler in a double blind cross-over study. Eleven male patients suffering from peripheral arterial obliterative disease (PAOD) in the second stage of Fontaine's classification, and 11 matched control subjects were enrolled in the study. Each subject received one of three different treatments on each day of the study in a different order following a random assignment. The treatments were either 30 mg x kg of L-acetylcarnitine (LAC) or 30 mg x kg of L-propionylcarnitine (LPC) or nitroglycerin (NTG) 1.25 mg given as a single i.v. bolus injected over 3 min. Echo-Doppler measurements of blood flow velocity, and cross-sectional area of the femoral artery were performed at baseline and 10, 20, and 30 min after injection the drugs. Pulsatility Index (an index derived from the blood flow velocity and related to vascular resistance: PI = Vmax - Vmin/Vmean) was also obtained each time. Results were analysed using a Student's t-test for paired data. L-acetylcarnitine and L-propionylcarnitine showed no haemodynamic effects in either group of subjects (controls and PAOD patients) whether blood flow or vascular resistance was considered. There were haemodynamic changes ( a decrease in blood flow velocity and an increase in arterial systemic resistance) only after NTG administration. The changes were more evident in controls than in PAOD patients. Femoral artery cross-sectional area showed no statistically significant effect as regards treatment. In conclusion, echo-Doppler flowmetry correctly assessed haemodynamic changes determined by the administration of NTG, whereas no changes were observed after LAC or LPC injection. Improvements in walking capacity after administration of these drugs could ony be related to metabolic effects
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