Document Detail

Carnitine and peripheral arterial disease.
MedLine Citation:
PMID:  15591006     Owner:  NLM     Status:  MEDLINE    
Patients with peripheral arterial disease (PAD) who become symptomatic with claudication (approximately one-third of the population) have a marked impairment in exercise performance and overall functional capacity. Patients with claudication have a peak oxygen consumption measured during graded treadmill exercise testing that is 50% of that in age-matched normal subjects, and also report great difficulty in walking relatively short distances, even at a slow walking speed. The reduced walking capacity is associated with impairment in activities of daily living and quality of life. Thus, claudication is highly limiting to the physical functioning of daily activities. Improving mobility and improving the reduced quality of life are therefore major goals of treatment. Patients with PAD develop metabolic abnormalities in the skeletal muscles of the lower extremity. These abnormalities include impairment in ischemic muscle mitochondrial electron transport chain activity and accumulation of intermediates of oxidative metabolism (acylcarnitines). Patients with the greatest accumulation of muscle acylcarnitines have the most impaired exercise performance. Thus, claudication is not simply the result of reduced blood flow, and alterations in skeletal muscle metabolism are part of the pathophysiology of the disease. L-carnitine and propionyl-L-carnitine may improve the metabolism and exercise performance of ischemic muscles. L-carnitine in a dose of 2 grams twice daily improved treadmill performance, but propionyl-L-carnitine (an acyl form of carnitine) was more effective than L-carnitine in improving treadmill walking distance. In two multicenter trials of a total of 730 patients, initial and maximal treadmill walking distance improved more with propionyl-L-carnitine than placebo. The drug also improved quality of life and had minimal side effects as compared with placebo. Propionyl-L-carnitine has not been approved for use in the United States.
William R Hiatt
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Annals of the New York Academy of Sciences     Volume:  1033     ISSN:  0077-8923     ISO Abbreviation:  Ann. N. Y. Acad. Sci.     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-12-13     Completed Date:  2005-03-04     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  7506858     Medline TA:  Ann N Y Acad Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  92-8     Citation Subset:  IM    
University of Colorado Health Sciences Center, Colorado Prevention Center, Denver, CO 80203, USA.
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MeSH Terms
Arterial Occlusive Diseases / drug therapy*,  physiopathology
Carnitine / analogs & derivatives*,  metabolism,  pharmacology*
Intermittent Claudication / drug therapy
Muscle, Skeletal / drug effects,  metabolism
Oxygen Consumption / physiology
Reg. No./Substance:
0/acylcarnitine; 17298-37-2/propionylcarnitine; 541-15-1/Carnitine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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