Opportunities of metabolic treatment in paroxysmal atrial fibrillation patients with obesity, arterial hypertension and/or ischemic heart disease

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This article provides the experience of examination and treatment of paroxysmal atrial fibrillation patients with concomitant obesity, arterial hypertension and/or ischemic heart disease, who were prescribed levocarnitine in addition to traditional therapy. The addition of levocarnitine in management of atrial fibrillation was found to be capable of reducing the atrial fibrillation burden after cardioversion and improve the functional state of the patients.

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Tatiana Balabanovich

Grodno State Medical University

编辑信件的主要联系方式.
Email: TatiBo1@yandex.ru
ORCID iD: 0000-0002-5552-8764
SPIN 代码: 8776-7636

MD, Cand. Sci. (Med.), Assistant Professor

白俄罗斯, Grodno

Valentina Golyshko

Grodno State Medical University

Email: vgolyshko@inbox.ru
ORCID iD: 0000-0001-9907-6192
SPIN 代码: 3743-3770

MD, Cand. Sci. (Med.), Assistant Professor

白俄罗斯, Grodno

Irina Sinkevich

City Clinical Hospital No. 3 of Grodno

Email: irina5897509@gmail.com

cardiologist

白俄罗斯, Grodno

Elen Shkuta

City Clinical Hospital No. 3 of Grodno

Email: ellashkuta@gmail.com

сlinical pharmacologist

白俄罗斯, Grodno

Elizaveta Veniadziktova

City Clinical Hospital No. 3 of Grodno

Email: agent.vms@gmail.com

cardiologist

白俄罗斯, Grodno

Pavel Baliuk

City Clinical Hospital No. 3 of Grodno

Email: pbalyuk98@mail.ru

cardiologist

白俄罗斯, Grodno

Alexei Knysh

City Clinical Hospital No. 3 of Grodno

Email: alekseiknysh19@ail.com

doctor of ultrasound diagnostics

白俄罗斯, Grodno

参考

  1. Hindricks G, Potpara T, Dagres N, et al. ESC Scientific Document Group. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021;42(5):373–498. doi: 10.1093/eurheartj/ehaa945
  2. Trohman RG, Huang HD, Sharma PS. Atrial fibrillation: primary prevention, secondary prevention, and prevention of thromboembolic complications: part 1. Front Cardiovasc Med. 2023;10:1060030. doi: 10.3389/fcvm.2023.1060030
  3. Vizzardi E, Curnis A, Latini MG, et al. Risk factors for atrial fibrillation recurrence: a literature review. J Cardiovasc Med (Hagerstown). 2014;15(3):235–253. doi: 10.2459/jcm.0b013e328358554b
  4. DiNicolantonio JJ, Lavie CJ, Fares H, et al. L-carnitine in the secondary prevention of cardiovascular disease: systematic review and meta-analysis. Mayo Clin Proc. 2013;88(6):544–551. doi: 10.1016/j.mayocp.2013.02.007
  5. Zhao G, Zhang H, Wang Y, et al. Effects of levocarnitine on cardiac function, urinary albumin, hs-CRP, BNP, and troponin in patients with coronary heart disease and heart failure. Hellenic J Cardiol. 2020;61(2):99–102. doi: 10.1016/j.hjc.2018.08.006
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  7. Dastan F, Talasaz AH, Mojtahedzadeh M, et al. Randomized trial of carnitine for the prevention of perioperative atrial fibrillation. Semin Thorac Cardiovasc Surg. 2018;30:7–13. doi: 10.1053/j.semtcvs.2017.08.006
  8. Shingu Y, Katoh N, Ooka T, et al. L-carnitine supplementation for the prevention of postoperative atrial fibrillation in aortic valve surgery. Gen Thorac Cardiovasc Surg. 2021;69(11):1460–1466. doi: 10.1007/s11748-021-01616-2
  9. Astashkin EI, Glezer MG. Cardiac lipotoxic effects of obesity. Arterial Hypertension. 2009;15(3):335–341. (In Russ.) doi: 10.18705/1607-419X-2009-15-3-335-341
  10. Zhang Y, Fu Y, Jiang T, et al. Enhancing fatty acids oxidation via L-carnitine attenuates obesity-related atrial fibrillation and structural remodeling by activating AMPK signaling and alleviating cardiac lipotoxicity. Front Pharmacol. 2021;12:771940. doi: 10.3389/fphar.2021.771940
  11. Muszyński P, Bonda TA. Mitochondrial dysfunction in atrial fibrillation-mechanisms and pharmacological interventions. J Clin Med. 2021;10(11):2385. doi: 10.3390/jcm10112385
  12. Gasparova I, Kubatka P, Opatrilova R, et al. Perspectives and challenges of antioxidant therapy for atrial fibrillation. Naunyn Schmiedebergs Arch Pharmacol. 2017;390(1):1–14. doi: 10.1007/s00210-016-1320-9
  13. Sciatti E, Lombardi C, Ravera A, et al.. Nutritional deficiency in patients with heart failure. Nutrients. 2016;8(7):442. doi: 10.3390/nu8070442
  14. Song X, Qu H, Yang Z, et al. Efficacy and safety of L-carnitine treatment for chronic heart failure: a meta-analysis of randomized controlled trials. Biomed Res Int. 2017;2017:6274854. doi: 10.1155/2017/6274854
  15. Trukhan DI. Role and location of L-carnitine in cytoprotection and correction of metabolic processes in patients with metabolic syndrome. Medical Council. 2017;(12):182–187. EDN: ZQTJYB doi: 10.21518/2079-701X-2017-12-182-187

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2. Fig. 1. Kaplan – Meier curves of end-point “atrial fibrillation recurrence”

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