K. Abrahamsson et al., TRANSIENT REDUCTION OF HUMAN LEFT-VENTRICULAR MASS IN CARNITINE DEPLETION INDUCED BY ANTIBIOTICS CONTAINING PIVALIC ACID, British Heart Journal, 74(6), 1995, pp. 656-659
Objective-To study the effect of induced carnitine depletion on myocar
dial structure and function. Subjects and Design-7 healthy adult volun
teers given 1200 mg pivmecillinam per day for 7-8 weeks were studied b
y echocardiography before and after 7-8 weeks of treatment and a 15 mo
nths follow up after the treatment period. Setting-Teaching hospital.
Main outcome measures-Carnitine concentration in serum, urine, and mus
cle and echocardiographic measurements. Results-After 7-8 weeks of tre
atment the median free serum carnitine concentration was reduced to 7%
and the median total muscle carnitine concentration to 46% of the pre
treatment levels. The median diastolic interventricular septum thickne
ss decreased by 14% (mean 26%, P = 0.028) and the median left ventricu
lar mass by 10% (mean 20%, P = 0.018). Fifteen months dimensions had i
ncreased completely returned to pretreatment values. Conclusions-Exten
ded treatment with pivalic acid containing antibiotics causes carnitin
e depletion which may lead to changes in cardiac structure.