Effect of Combination of L-Arginine and L-Carnitine on Serum AGEs Level, Kidney and Endothelial Function in Patients with Chronic Heart Failure

Olexandr Kuryata, Oksana Sirenko, Abdunaser Zabida

Abstract


The aim of the study to evaluate the effect of combination of L-Arginine with L-Carnitine on GFR, serum AGEs level and endothelial function in chronic heart failure (HF) patients with preserved ejection fraction (HFpEF).

Materials and Methods: 35 patients with mean age 60,1 [56,7; 77,3] years with an established diagnosis of HFpEF were enrolled. The patients were randomly and blindly divided into 2 groups: first (1st) group pts were treated with a combination of L-Carnitine and L-Arginine in addition to standard treatment; 2nd group pts – with L-Arginine in addition to conventional treatment. Standard laboratory blood tests, lipid profile, glucose, renal and liver function tests, serum advanced glycation end-product (AGEs) level, echocardiographic examination, flow-mediated dilatation (FMD%) were performed for all patients baseline and after 10 days of treatment. The glomerular filtration rate (GFR) was estimated using the CKD-EPI formula.

Results: Median level of AGEs was 1.72 [1.34; 1.93] mg/ml. The level of AGEs was correlated with age (R = 0.71, p<0.05), disease duration (R = 0.69, p<0.05). After 10 days of treatment with a combination of L-Carnitine with L-Arginine mean AGEs was decreased by 13.1% in comparison with L-Arginine treatment group (p=0.0003). After the treatment in 1st group mean AGEs was significantly lower in comparison with the 2nd group (p=0.004). Baseline median level of GFR was 81.2 [72,1; 86,2] ml/min and correlated with disease duration (R = 0.71, p<0.05), AGEs level (R = -0.73, p<0.05). The inclusion combination of L-arginine aspartate with L-Carnitine contributed to the significant increase of GFR level (p=0.003). The median FMD% level was 6.2 [4.4; 7.9] % and correlated with age (R=-0.61, p < 0.05), GFR (R=0.54, p < 0.05). After the 10 days it had been established significant increasing of FMD% level on 47.9 % in 1st group (p=0.0005), and on 29.3 % in 2nd group (p=0.003). Endothelial function normalizing was achieved in 10 (66 %) pts of 1st group and in 9 (45%) pts of 2nd group (p=0.002).

Conclusion: The combination of L-Carnitine, and L-Arginine improves kidney, endothelial function and contributes to decreasing of AGEs level in pts with HFpEF.

Keywords


L-arginine, L-carnitine, kidney function, endothelial function, chronic heart failure.

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ISSN: 1929-5634