Evidence map›Paper›PMID 38568244›Full record

Trial reportEuropean journal of pediatrics2024

L-carnitine decreases myocardial injury in children undergoing open-heart surgery: A randomized controlled trial.

Wael El Feky, Dalia El-Afify, Dina Abdelhai, Mohamed Elkashlan, Ahmed Fakhreldin, Doaa El Amrousy

Open access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in European journal of pediatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Wael El FekyCardiothoracic Surgery Department, Faculty of Medicine, Kafr Elsheikh University, Kafr Elsheikh, Egypt.
Dalia El-AfifyClinical Pharmacy Department, Faculty of Pharmacy, Tanta University, Tanta, Egypt.
Dina AbdelhaiClinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Mohamed ElkashlanAnesthesia Department, Elmenshawy Hospital, Ministry of Health, Tanta, Egypt.
Ahmed FakhreldinPediatric Department, Faculty of Medicine, Aswan University, Aswan, Egypt.
Doaa El AmrousyPediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt. doaa.moha@med.tanta.edu.eg.
Tanta University · EGAswan University · EGKafrelsheikh University · EG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Myocardial injury in open-heart surgery is related to several factors including ischemia-reperfusion injury, generation of reactive oxygen species, increased production of inflammatory mediators, and enhancement of apoptosis of cardiomyocytes. The aim of this study was to study the effect of L-carnitine on myocardial injury in children undergoing open-heart surgery. This clinical trial was performed on 60 children with congenital heart disease (CHD) who underwent open-heart surgery. They were randomized into two groups: L-carnitine group who received L-carnitine 50 mg\kg\day once daily for 1 month before cardiac surgery and control group who received placebo for 1 month before cardiac surgery. Left ventricular cardiac function was assessed by conventional echocardiography to measure left ventricular ejection fraction (LVEF) and two-dimensional speckle tracking echocardiography (2D-STE) to determine left ventricular global longitudinal strain (2D-LV GLS). Blood samples were obtained pre-operatively at baseline before the administration of L-carnitine or placebo and 12 h post-operatively to measure the level of malondialdehyde (MDA), superoxide dismutase (SOD), fas, caspase-3, creatinine kinase-MB (CK-MB), and troponin I. L-carnitine group had significantly lower post-operative level of oxidative stress marker (MDA), apoptosis markers (fas and caspase-3), and myocardial injury markers (CK-MB and troponin I), but they had significantly higher SOD post-operative level compared to the control group. In addition, post-operative LVEF and 2D-LVGLS were significantly lower in the control group compared to L-carnitine group.   Conclusion: L-carnitine can reduce myocardial injury, improve post-operative left ventricular cardiac function, and may provide myocardium protection in children with CHD who underwent open-heart surgery.   Trial registration: The clinical trial was registered at www.pactr.org with registration number PACTR202010570607420 at 29/10/2020 before recruiting the patients. What is Known: • Myocardial injury in open-heart surgery is related to several factors including ischemia-reperfusion injury, generation of reactive oxygen species, increased production of inflammatory mediators, and enhancement of apoptosis of cardiomyocytes. • L-carnitine was reported to have myocardial protective effects in rheumatic valvular surgery and coronary artery bypass graft (CABG) in adults; however, there is no evidence on its effectiveness in children undergoing open-heart surgery. What is New: • L-carnitine significantly lowered the post-operative level of oxidative stress marker (MDA), apoptosis markers (fas and caspase-3), and myocardial injury markers (CK-MB and troponin I) in the treatment group. • L-carnitine can reduce myocardial injury, improve post-operative left ventricular cardiac function, and may provide myocardium protection in children with CHD who underwent open-heart surgery.

Indexed as

Cardiac Surgical ProceduresCarnitineEchocardiographyHeart Defects, CongenitalOxidative StressApoptosisBiomarkersChildChild, PreschoolDouble-Blind MethodFemaleHumansInfantMaleMyocardial Reperfusion InjuryPostoperative ComplicationsBiomarkersCarnitineApoptosisChildrenL-carnitineOpen-heart surgeryOxidative stress

Identifiers

PMID38568244
PMCPMC11098932
OpenAlexW4393854250

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.