COMPARISON BETWEEN THE EFFECT OF L-PROPIONYLCARNITINE, L-ACETYLCARNITINE AND NITROGLYCERIN IN CHRONIC PERIPHERAL ARTERIAL-DISEASE - A HEMODYNAMIC DOUBLE-BLIND ECHO-DOPPLER STUDY

The haemodynamic effects on the peripheral vascular bed of L-acetylcar nitine, L-propionylcarnitine, and nitroglycerin were tested by echo-Do ppler in a double blind cross-over study. Eleven male patients sufferi ng from peripheral arterial obliterative disease (PAOD) in the second stage of Fontaine's classification, and 11 matched control subjects we re enrolled in the study. Each subject received one of three different treatments on each day of the study in a different order following a random assignment. The treatments were either 30 mg x kg of L-acetylca rnitine (LAC) or 30 mg x kg of L-propionylcarnitine (LPC) or nitroglyc erin (NTG) 1.25 mg given as a single i.v. bolus injected over 3 min. E cho-Doppler measurements of blood flow velocity, and cross-sectional a rea of the femoral artery were performed at baseline and 10, 20, and 3 0 min after injection the drugs. Pulsatility Index (an index derived f rom the blood flow velocity and related to vascular resistance: PI = V max - Vmin/Vmean) was also obtained each time. Results were analysed u sing a Student's t-test for paired data. L-acetylcarnitine and L-propi onylcarnitine showed no haemodynamic effects in either group of subjec ts (controls and PAOD patients) whether blood flow or vascular resista nce was considered. There were haemodynamic changes ( a decrease in bl ood flow velocity and an increase in arterial systemic resistance) onl y after NTG administration. The changes were more evident in controls than in PAOD patients. Femoral artery cross-sectional area showed no s tatistically significant effect as regards treatment. In conclusion, e cho-Doppler flowmetry correctly assessed haemodynamic changes determin ed by the administration of NTG, whereas no changes were observed afte r LAC or LPC injection. Improvements in walking capacity after adminis tration of these drugs could ony be related to metabolic effects.