Reduction of cardiac toxicity of anthracyclines by L-carnitine: preliminary overview of clinical data

Int J Clin Pharmacol Res. 1985;5(2):137-42.

Abstract

Doxorubicin is one of the most effective antineoplastic agents but its limited use is due to acute and chronic cardiotoxicity. These side-effects are irreversible and dose-dependent, occurring in one-third of the patients treated after a cumulative dose of 300 mg/m2. It has been suggested that the problem of acute and chronic cardiotoxicity may be prevented by using L-carnitine. Hence nine patients receiving a cumulative dose (200-490 mg/m2) of doxorubicin have been studied. Acute cardiotoxicity has been evaluated by creatine kinase---marsh bender (MB) serum levels before and 15 h after treatment. Data demonstrated no significant increase of isoenzyme-MB after doxorubicin administration. Chronic cardiotoxicity has been monitored studying the electrocardiograph and the left ventricular performance by computerized M-Mode echocardiography measuring the maximal velocity of circumferential fibre shortening (VCF Max) which is considered a reliable and very sensitive non-invasive parameter to evaluate myocardial contractility. The results show a decrease in VCF Max (measured in diameter/cardiac cycle) from 1.7 +/- 0.4 to 1.4 +/- 0.3 but still within normal values. So the systematic use of L-carnitine as adjuvant therapy is proposed during doxorubicin administration.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antibiotics, Antineoplastic
  • Carnitine / therapeutic use*
  • Creatine Kinase / blood
  • Doxorubicin / adverse effects
  • Doxorubicin / antagonists & inhibitors
  • Doxorubicin / therapeutic use
  • Echocardiography
  • Electrocardiography
  • Female
  • Heart Diseases / chemically induced
  • Heart Diseases / prevention & control*
  • Humans
  • Male
  • Middle Aged
  • Naphthacenes / adverse effects
  • Naphthacenes / antagonists & inhibitors
  • Neoplasms / drug therapy

Substances

  • Antibiotics, Antineoplastic
  • Naphthacenes
  • Doxorubicin
  • Creatine Kinase
  • Carnitine