Effects of oral administration of orodispersible levo-carnosine on quality of life and exercise performance in patients with chronic heart failure

Nutrition. 2015 Jan;31(1):72-8. doi: 10.1016/j.nut.2014.04.021. Epub 2014 May 10.


Objective: Chronic heart failure (CHF) is characterized by several micronutrient deficits. Amino acid supplementation may have a positive effect on nutritional and metabolic status in patients with CHF. Levo-carnosine (β-alanyl-L-histidine) is expressed at a high concentration in myocardium and muscle. Preliminary studies with L-carnosine in healthy individuals have suggested a potential role in improving exercise performance. To our knowledge, no study has been conducted in patients with heart failure. The aim of this study was to test the oral supplementation of L-carnosine and its effects on quality of life and exercise performance in patients with stable CHF.

Methods: Fifty patients with stable CHF and severe left-ventricular systolic dysfunction on optimal medical therapy were randomized 1:1 to receive oral orodispersible L-carnosine (500 mg OD) or standard treatment. Left-ventricular ejection fraction (LVEF) was measured by echocardiography. Cardiopulmonary stress test, 6-minute walking test (6 MWT) and quality-of-life (visual analog scale score and the EuroQOL five dimensions questionnaire [EQ-5D]) were performed at baseline and after 6 mo.

Results: Patients receiving orodispersible L-carnosine had an improvement in 6 MWT distance (P = 0.014) and in quality-of-life (VAS score) (P = 0.039) between baseline and follow-up. Compared with controls, diet supplementation with orodispersible L-carnosine was associated with an improvement in peakVO2 (P < 0.0001), VO2 at anaerobic threshold, peak exercise workload, 6 MWT and quality-of-life assessed by the EQ-5D test and the VAS score.

Conclusion: This study suggests that L-carnosine, added to conventional therapy, has beneficial effects on exercise performance and quality of life in stable CHF. More data are necessary to evaluate its effects on left-ventricular ejection fraction and prognosis in CHF.

Keywords: Amino acids; Cardiopulmonary exercise test; Chronic heart failure; Levo-carnosine; Micronutrient; Quality of life.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Aged
  • Anaerobic Threshold
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Blood Glucose / metabolism
  • Carnosine / administration & dosage*
  • Cholesterol / blood
  • Chronic Disease
  • Dietary Supplements*
  • Dose-Response Relationship, Drug
  • Echocardiography
  • Exercise Test
  • Exercise*
  • Female
  • Heart Failure / drug therapy*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Quality of Life*
  • Triglycerides / blood
  • Ventricular Function, Left
  • Walking


  • Angiotensin-Converting Enzyme Inhibitors
  • Blood Glucose
  • Triglycerides
  • Carnosine
  • Cholesterol