[The role of L-carnitine in nutritional status and echocardiographic parameters in idiopathic dilated cardiomyopathy in children]. / O papel da L-carnitina no estado nutricional e na evolução ecocardiográfica da cardiomiopatia dilatada idiopática da infância.

ABSTRACT

OBJECTIVES: Malnutrition is an independent predictor of death in idiopathic dilated cardiomyopathy. An analysis was performed of the impact of L-carnitine supplementation on the nutritional status and echocardiogram parameters of children with idiopathic dilated cardiomyopathy. METHODS: This was an open label cohort of 11 patients who received L-carnitine (100 mg/kg/day) plus the conventional medical treatment, compared with 40 controls, matched for gender and age. The L-carnitine group was weighed 118 times and the controls 264 times. Additionally, the L-carnitine group underwent 65 two-dimensional echocardiograms and the controls 144. Chi-square, Student's t test, Person correlation and ANOVA were calculated with alpha = 0.05. RESULTS: For the L-carnitine group age at presentation = 3.82 years old, 72.7% (p = 0.033) were females younger than 2 years and 90.9% (p = 0.0001) were in functional classes III and IV. There were no deaths during this period. At presentation, no differences were observed in weight percentile (31.2+/-8.74 vs. 19.6+/-21.2) (p = 0.29) or z score (-0.68+/-1.05 vs. -1.16+/-0.89) (p = 0.24). Increases were observed in both the percentile (p = 0.026) and z score (p = 0.033) after the introduction of L-carnitine. At presentation, there were no differences in ejection fraction (54.9%+/-3.8 vs. 49.3%+/-6.6) (p = 0.19), but LV mass/BSA were greater in the L-carnitine group (169.12 g/m2+/-26.24 vs. 110.67 g/m2+/-15.62) (p = 0.0005). After the introduction of L-carnitine an increase in ejection fraction (48.3+/-7 to 67.2+/-7) (p = 0.044) was observed. LV mass/BSA decreased (164.29 g/m2+/-28.14 to 110.88 g/m2+/-28.88), but without significance (p = 0.089) CONCLUSION: In children with idiopathic dilated cardiomyopathy, supplementation of L-carnitine may be helpful for nutritional and echocardiographic improvement.