Effect of Levocarnitine on the Therapeutic Efficacy of Conventional Therapy in Children with Dilated Cardiomyopathy: Results of a Randomized Trial in 29 Children

Abstract

Background: The effect of levocarnitine supplementation has not been evaluated in children with dilated cardiomyopathy (DCM). Objective: The aim of this study was to explore the effect of oral levocarnitine supplementation in pediatric patients with DCM. Methods: Twenty-nine children with DCM (17 male, 12 female, aged 1 month to 13 years) were divided into two groups according to a simple randomization: control group (n = 10) and experimental group (n = 19). All children were given oral hydrochlorothiazide, enalapril, and spironolactone; additionally, patients with cardiac function of NYHA grade IV were given oral digoxin, and patients with intractable heart failure were given intravenous dopamine and dobutamine. When cardiac function was restored to NYHA grade II–III, patients were given oral metoprolol. Patients in the experimental group received add-on treatment with oral levocarnitine solution (50–100 mg/kg/day). Patients were followed up at 1, 3, 6 and 12 months. Left ventricular ejection fraction (EF), short axis shortening (FS), and left atrium (LA) and left ventricle (LV) diameters were measured at different times during the follow-up. Results: The children with DCM were followed up for 1 year. Cardiac function was significantly improved in the experimental group compared with the control group. Specifically, the EF and FS were increased (p < 0.05), the LA and LV diameters were reduced (p < 0.05), and the EF was increased more significantly in the experimental group than in the control group (p < 0.05). Conclusions: Oral levocarnitine solution appeared to enhance the therapeutic efficacy of conventional therapy in children with DCM.