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Purpose <p>Heart failure is a significant complication among patients undergoing hemodialysis, often associated with left ventricular hypertrophy and dysfunction. L-carnitine, crucial for fatty acid metabolism, has shown promise in improving cardiac function. This systematic review and meta-analysis aim to evaluate the safety and efficacy of L-carnitine supplementation in improving cardiac function in hemodialysis patients.</p> Methodology <p>A comprehensive search of PubMed, Cochrane, and EMBASE was conducted up to October 3, 2024, to identify relevant studies. The trials assessing the effects of L-carnitine on echocardiographic parameters such as left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI), and diastolic function were included. A random-effects model was applied to pool data, and heterogeneity was assessed using the <i>I</i><sup>2</sup> statistic.</p> Results <p>A total of 23 studies were included in the systematic review, with 7 studies involving 426 participants being meta-analyzed. L-carnitine supplementation significantly improved LVEF (MD = 1.64, 95% CI 0.10–3.17, <i>p</i> = 0.04), with low heterogeneity (<i>I</i><sup>2</sup> = 37%). However, no significant changes were observed for LVMI (MD = −3.19, <i>p</i> = 0.60) or diastolic markers (<i>E</i>/<i>A</i> ratio MD = −0.13, <i>p</i> = 0.47; <i>E</i>/<i>e</i> ratio MD = −0.35, <i>p</i> = 0.67).</p> Conclusion <p>L-carnitine supplementation significantly improves cardiac function, particularly systolic function (LVEF) in hemodialysis patients. However, its effects on LVMI and markers of diastolic function are inconclusive. Future large-scale trials are warranted to further elucidate its role in cardiac function among this population.</p>

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Safety and efficacy of L-carnitine supplementation in improving cardiac function of hemodialysis patients: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2025年4月2日

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  • Rayyan Nabi,
  • Hanzala Ahmed Farooqi,
  • Sabahat Ul Ain Munir Abbasi,
  • Najaf Ahmed Rajpar,
  • Aqsa Munir,
  • Hamza Bin Ahmed,
  • Uzair Iqbal,
  • Tabeer Zahid,
  • Zahid Nabi

摘要

Purpose

Heart failure is a significant complication among patients undergoing hemodialysis, often associated with left ventricular hypertrophy and dysfunction. L-carnitine, crucial for fatty acid metabolism, has shown promise in improving cardiac function. This systematic review and meta-analysis aim to evaluate the safety and efficacy of L-carnitine supplementation in improving cardiac function in hemodialysis patients.

Methodology

A comprehensive search of PubMed, Cochrane, and EMBASE was conducted up to October 3, 2024, to identify relevant studies. The trials assessing the effects of L-carnitine on echocardiographic parameters such as left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI), and diastolic function were included. A random-effects model was applied to pool data, and heterogeneity was assessed using the I2 statistic.

Results

A total of 23 studies were included in the systematic review, with 7 studies involving 426 participants being meta-analyzed. L-carnitine supplementation significantly improved LVEF (MD = 1.64, 95% CI 0.10–3.17, p = 0.04), with low heterogeneity (I2 = 37%). However, no significant changes were observed for LVMI (MD = −3.19, p = 0.60) or diastolic markers (E/A ratio MD = −0.13, p = 0.47; E/e ratio MD = −0.35, p = 0.67).

Conclusion

L-carnitine supplementation significantly improves cardiac function, particularly systolic function (LVEF) in hemodialysis patients. However, its effects on LVMI and markers of diastolic function are inconclusive. Future large-scale trials are warranted to further elucidate its role in cardiac function among this population.