Pharmacological effects and clinical applications of propionyl-L-carnitine

Nutrition Reviews

Volumn 69, Issue 5, 2011, Pages 279-290

  Mingorance, Carmen ^a   Rodriguez Rodriguez, Rosalia ^a   Justo, Maria Luisa ^a   Herrera, Maria Dolores ^a   de Sotomayor, Maria Alvarez ^a  

^a UNIVERSITY OF SEVILLE   (Spain)

Author keywords

Cardiovascular disease; Clinical applications; Insulin resistance; Pharmacological effects; Propionyl L carnitine

Indexed keywords

ADENOSINE TRIPHOSPHATE; PROPIONYLCARNITINE;

ARTERY DISEASE; ARTICLE; ATHEROSCLEROSIS; CARBOHYDRATE METABOLISM; CLINICAL TRIAL (TOPIC); ENDOTHELIAL DYSFUNCTION; HEART DISEASE; HEART FAILURE; HEART MUSCLE ISCHEMIA; HEART PROTECTION; HEMODIALYSIS PATIENT; HUMAN; HYPERGLYCEMIA; INSULIN RESISTANCE; LIPID METABOLISM; NON INSULIN DEPENDENT DIABETES MELLITUS; NONHUMAN; OXIDATIVE STRESS; STABLE ANGINA PECTORIS;

ADENOSINE TRIPHOSPHATE; ATHEROSCLEROSIS; CARBOHYDRATE METABOLISM; CARDIOTONIC AGENTS; CARNITINE; ENDOTHELIUM; FREE RADICAL SCAVENGERS; HEART; HUMANS; INSULIN RESISTANCE; LIPID METABOLISM; OXIDATIVE STRESS;

ANGINA;

EID: 79955421173     PISSN: 00296643     EISSN: 17534887     Source Type: Journal    
DOI: 10.1111/j.1753-4887.2011.00387.x     Document Type: Article

References (113)

1. Ramsay RR, Zammit VA. Carnitine acyltransferases and their influence on CoA pools in health and disease. Mol Aspects Med. 2004;25:475-493.
2. Zhang H, Jia H, Liu J, etal. Combined R-alpha-lipoic acid and acetyl-L-carnitine exerts efficient preventative effects in a cellular model of Parkinson's disease. J Cell Mol Med. 2010;14:215-225.
3. Shenk JC, Liu J, Fischbach K, etal. The effect of acetyl-L-carnitine and R-alpha-lipoic acid treatment in ApoE4 mouse as a model of human Alzheimer's disease. J Neurol Sci. 2009;283:199-206.
4. Nagesh Babu G, Kumar A, Singh RL. Chronic pretreatment with acetyl-L-carnitine and ±DL-α-lipoic acid protects against acute glutamate-induced neurotoxicity in rat brain by altering mitochondrial function. Neurotox Res. 2011;19:319-329.
5. Ruggenenti P, Cattaneo D, Loriga G, etal. Ameliorating hypertension and insulin resistance in subjects at increased cardiovascular risk: effects of acetyl-L-carnitine therapy. Hypertension. 2009;54:567-574.
6. Siliprandi N, Di Lisa F, Menabò R. Propionyl-L-carnitine: biochemical significance and possible role in cardiac metabolism. Cardiovasc Drugs Ther. 1991;5:11-15.
7. Lango R, Smolenski RT, Narkiewicz M, Suchorzewska J, Lysiak-Szydlowska W. Influence of L-carnitine and its derivatives on myocardial metabolism and function in ischemic heart disease and during cardiopulmonary bypass. Cardiovasc Res. 2001;51:21-29.
8. Vanella A, Russo A, Acquaviva R, etal. L -propionyl-carnitine as superoxide scavenger, antioxidant, and DNA cleavage protector. Cell Biol Toxicol. 2000;16:99-104.
9. Hülsmann WC. Biochemical profile of propionyl-L-carnitine. Cardiovasc Drugs Ther. 1991;5:7-9.
10. Arduini A, Gorbunov N, Arrigoni-Martelli E, etal. Effects of L-carnitine and its acetate and propionate esters on the molecular dynamics of human erythrocyte membrane. Biochim Biophys Acta. 1993;1146:229-235.
11. Arduini A, Dottori S, Sciarroni AF, etal. Effect of propionyl-L-carnitine treatment on membrane phospholipid fatty acid turnover in diabetic rat erythrocytes. Mol Cell Biochem. 1995;152:31-37.
12. Davenport RJ, Law MP, Pike VW, Osman S, Poole KG. Propionyl-L-carnitine: labelling in the N-methyl position with carbon-11 and pharmacokinetic studies in rats. Nucl Med Biol. 1995;22:699-709.
13. Arsenian MA. Carnitine and its derivatives in cardiovascular disease. Prog Cardiovasc Dis. 1997;40:265-286.
14. Russell RR, Mommessin JI, Taegtmeyer H. Propionyl-L-carnitine-mediated improvement in contractile function of rat hearts oxidizing acetoacetate. Am J Physiol. 1995;268(1 Pt 2):H441-H447.
15. Paulson DJ, Traxler J, Schmidt M, Noonan J, Shug AL. Protection of the ischaemic myocardium by L-propionylcarnitine: effects on the recovery of cardiac output after ischaemia and reperfusion, carnitine transport, and fatty acid oxidation. Cardiovasc Res. 1986;20:536-541.
16. Ferrari R, Ceconi C, Curello S, Pasini E, Visioli O. Protective effect of propionyl-L-carnitine against ischaemia and reperfusion-damage. Mol Cell Biochem. 1989;88:161-168.
17. Mombouli JV, Vanhoutte PM. Endothelial dysfunction: from physiology to therapy. J Mol Cell Cardiol. 1999;31:61-74.
18. Herrera MD, Mingorance C, Rodríguez-Rodríguez R, Alvarez de Sotomayor M. Endothelial dysfunction and aging: an update. Ageing Res Rev. 2010;9:142-152.
19. Félétou M, Vanhoutte PM. Endothelial dysfunction: a multifaceted disorder (The Wiggers Award Lecture). Am J Physiol Heart Circ Physiol. 2006;291:H985-H1002.
20. Victor VM, Rocha M, Solá E, Bañuls C, Garcia-Malpartida K, Hernández-Mijares A. Oxidative stress, endothelial dysfunction and atherosclerosis. Curr Pharm Des. 2009;15:2988-3002.
21. Bertelli A, Giovannini L, Galmozzi G, Bertelli AA. Protective role of propionyl carnitine in vascular disorders experimentally induced by endothelin (ET-1) serotonin and K-carrageenin. Drugs Exp Clin Res. 1993;19:7-11.
22. Bertelli A, Bertelli AA, Galmozzi G, Giovannini L, Mian M. Thrombosis induced by endothelin (ET-1) and carrageenin in rats treated with indomethacin and propionyl carnitine. Drugs Exp Clin Res. 1993;19:75-78.
23. Bertelli A, Bertelli AA, Giovannini L. The potentiating effect of propionyl carnitine on prostacycline prevention of thrombosis induced by endothelin (ET-1) and K-carrageenin. Drugs Exp Clin Res. 1994;20:7-11.
24. Herrera MD, Bueno R, De Sotomayor MA, Pérez-Guerrero C, Vázquez CM, Marhuenda E. Endothelium-dependent vasorelaxation induced by L-carnitine in isolated aorta from normotensive and hypertensive rats. J Pharm Pharmacol. 2002;54:1423-1427.
25. Bueno R, Alvarez de Sotomayor M, Perez-Guerrero C, Gómez-Amores L, Vazquez CM, Herrera MD. L-carnitine and propionyl-L-carnitine improve endothelial dysfunction in spontaneously hypertensive rats: different participation of NO and COX-products. Life Sci. 2005;77:2082-2097.
26. Cipolla MJ, Nicoloff A, Rebello T, Amato A, Porter JM. Propionyl-L-carnitine dilates human subcutaneous arteries through an endothelium-dependent mechanism. J Vasc Surg. 1999;29:1097-1103.
27. Wang HD, Pagano PJ, Du Y, etal. Superoxide anion from the adventitia of the rat thoracic aorta inactivates nitric oxide. Circ Res. 1998;82:810-818.
28. Bertelli A, Conte A, Ronca G, Segnini D, Yu G. Protective effect of propionyl carnitine against peroxidative damage to arterial endothelium membranes. Int J Tissue React. 1991;13:41-43.
29. Bertelli A, Conte A, Palmieri L, Ronca G, Segnini D, Yu G. Effect of propionyl carnitine on energy charge and adenine nucleotide content of cardiac endothelial cells during hypoxia. Int J Tissue React. 1991;13:37-40.
30. Calò LA, Pagnin E, Davis PA, etal. Antioxidant effect of L-carnitine and its short chain esters: relevance for theprotection from oxidative stress related cardiovascular damage. Int J Cardiol. 2006;107:54-60.
31. de Sotomayor MA, Mingorance C, Rodriguez-Rodriguez R, Marhuenda E, Herrera MD. l-carnitine and its propionate: improvement of endothelial function in SHR through superoxide dismutase-dependent mechanisms. Free Radic Res. 2007;41:884-891.
32. Alvarez de Sotomayor M, Bueno R, Pérez-Guerrero C, Herrera MD. Effect of L-carnitine and propionyl-L-carnitine on endothelial function of small mesenteric arteries from SHR. J Vasc Res. 2007;44:354-364.
33. Libby P. Inflammation in atherosclerosis. Nature. 2002;420:868-874.
34. Spagnoli LG, Orlandi A, Marino B, Mauriello A, De Angelis C, Ramacci MT. Propionyl-L-carnitine prevents the progression of atherosclerotic lesions in aged hyperlipemic rabbits. Atherosclerosis. 1995;114:29-44.
35. Orlandi A, Marcellini M, Pesce D, Calvani M, Spagnoli LG. Propionyl-L-carnitine reduces intimal hyperplasia after injury in normocholesterolemic rabbit carotid artery by modulating proliferation and caspase 3-dependent apoptosis of vascular smooth muscle cells. Atherosclerosis. 2002;160:81-89.
36. Orlandi A, Francesconi A, Marcellini M, Di Lascio A, Spagnoli LG. Propionyl-L-carnitine reduces proliferation and potentiates Bax-related apoptosis of aortic intimal smooth muscle cells by modulating nuclear factor-kappaB activity. J Biol Chem. 2007;282:4932-4942.
37. Orlandi A, Francesconi A, Ferlosio A, etal. Propionyl-L-carnitine prevents age-related myocardial remodeling in the rabbit. J Cardiovasc Pharmacol. 2007;50:168-175.
38. Calvani M, Reda E, Arrigoni-Martelli E. Regulation by carnitine of myocardial fatty acid and carbohydrate metabolism under normal and pathological conditions. Basic Res Cardiol. 2000;95:75-83.
39. Bertelli A, Conte A, Ronca G, Zucchi R. Effect of propionyl carnitine on cardiac energy metabolism evaluated by the release of purine catabolites. Drugs Exp Clin Res. 1991;17:115-118.
40. Ferrari R, Pasini E, Condorelli E, etal. Effect of propionyl-L-carnitine on mechanical function of isolated rabbit heart. Cardiovasc Drugs Ther. 1991;5:17-23.
41. Ferrari R, Di Lisa F, de Jong JW, etal. Prolonged propionyl-L-carnitine pre-treatment of rabbit: biochemical, hemodynamic and electrophysiological effects on myocardium. J Mol Cell Cardiol. 1992;24:219-232.
42. Pasini E, Comini L, Ferrari R, de Giuli F, Menotti A, Dhalla NS. Effect of propionyl-L-carnitine on experimental induced cardiomyopathy in rats. Am J Cardiovasc Pathol. 1992;4:216-222.
43. Cevese A, Schena F, Cerutti G. Short-term hemodynamic effects of intravenous propionyl-L-carnitine in anesthetized dogs. Drugs Exp Clin Res. 1992;18:475-480.
44. Maresca P, Mancinelli R, Corsico N, Arrigoni-Martelli E, Manni E. Positive action of propionyl-L-carnitine on mechanical performance of papillary muscle from Syrian hamsters with hereditary dilated cardiomyopathy. Eur J Pharmacol. 1995;287:303-307.
45. Vargiu R, Littarru GP, Faa G, Mancinelli R. Positive inotropic effect of coenzyme Q10, omega-3 fatty acids and propionyl-L-carnitine on papillary muscle force-frequency responses of BIO TO-2 cardiomyopathic Syrian hamsters. Biofactors. 2008;32:135-144.
46. Koh SG, Brenner DA, Korzick DH, Tickerhoof MM, Apstein CS, Saupe KW. Exercise intolerance during post-MI heart failure in rats: prevention with supplemental dietary propionyl-L-carnitine. Cardiovasc Drugs Ther. 2003;17:7-14.
47. Leasure JE, Kordenat K. Effect of propionyl-L-carnitine on experimental myocardial infarction in dogs. Cardiovasc Drugs Ther. 1991;5:85-95.
48. Sethi R, Wang X, Ferrari R, Dhalla NS. Improvement of cardiac function and beta-adrenergic signal transduction by propionyl L-carnitine in congestive heart failure due to myocardial infarction. Coron Artery Dis. 2004;15:65-71.
49. Ferrari R, Ceconi C, Cargnoni A, etal. The effect of propionyl-L-carnitine on the ischemic and reperfused intact myocardium and on their derived mitochondria. Cardiovasc Drugs Ther. 1991;5:57-65.
50. Packer L, Valenza M, Serbinova E, Starke-Reed P, Frost K, Kagan V. Free radical scavenging is involved in the protective effect of L-propionyl-carnitine against ischemia-reperfusion injury of the heart. Arch Biochem Biophys. 1991;288:533-537.
51. Reznick AZ, Kagan VE, Ramsey R, etal. Antiradical effects in L-propionyl carnitine protection of the heart against ischemia-reperfusion injury: the possible role of iron chelation. Arch Biochem Biophys. 1992;296:394-401.
52. Broderick TL, Quinney HA, Lopaschuk GD. L-Carnitine increases glucose metabolism and mechanical function following ischaemia in diabetic rat heart. Cardiovasc. Res. 1995;29:373-378.
53. Martin MA, Gomez MA, Guillen F, etal. Myocardial carnitine and carnitine palmitoyltransferase deficiencies in patients with severe heart failure. Biochim Biophys Acta. 2000;1502:330-336.
54. Broderick TL. Hypocarnitinaemia induced by sodium pivalate in the rat is associated with left ventricular dysfunction and impaired energy metabolism. Drugs R D. 2006;7:153-161.
55. Shug A, Paulson D, Subramanian R, Regitz V. Protective effects of propionyl-L-carnitine during ischemia and reperfusion. Cardiovasc Drugs Ther. 1991;5:77-83.
56. Di Lisa F, Menabò R, Siliprandi N. L-propionyl-carnitine protection of mitochondria in ischemic rat hearts. Mol Cell Biochem. 1989;88:169-173.
57. Löster H, Keller T, Grommisch J, Gründer W. Effects of L-carnitine and its acetyl and propionyl esters on ATP and PCr levels of isolated rat hearts perfused without fatty acids and investigated by means of 31P-NMR spectroscopy. Mol Cell Biochem. 1999;200:93-102.
58. Tassani V, Cattapan F, Magnanimi L, Peschechera A. Anaplerotic effect of propionyl carnitine in rat heart mitochondria. Biochem Biophys Res Commun. 1994;199:949-953.
59. Felix C, Gillis M, Driedzic WR, Paulson DJ, Broderick TL. Effects of propionyl-L-carnitine on isolated mitochondrial function in the reperfused diabetic rat heart. Diabetes Res Clin Pract. 2001;53:17-24.
60. Broderick TL. ATP production and TCA activity are stimulated by propionyl-L-carnitine in the diabetic rat heart. Drugs R D. 2008;9:83-91.
61. Broderick TL, Quinney HA, Lopaschuk GD. Carnitine stimulation of glucose oxidation in the fatty acid perfused isolated working rat heart. J Biol Chem. 1992;267:3758-3763.
62. El Alaoui-Talibi Z, Guendouz A, Moravec M, Moravec J. Control of oxidative metabolism in volume-overloaded rat hearts: effect of propionyl-L-carnitine. Am J Physiol. 1997;272:H1615-H1624.
63. Motterlini R, Samaja M, Tarantola M, Micheletti R, Bianchi G. Functional and metabolic effects of propionyl-L-carnitine in the isolated perfused hypertrophied rat heart. Mol Cell Biochem. 1992;116:139-145.
64. Torielli L, Conti F, Cinato E, etal. Alterations in energy metabolism of hypertrophied rat cardiomyocytes: influence of propionyl-L-carnitine. J Cardiovasc Pharmacol. 1995;26:372-380.
65. el Alaoui-Talibi Z, Bouhaddioni N, Moravec J. Assessment of the cardiostimulant action of propionyl-L-carnitine on chronically volume-overloaded rat hearts. Cardiovasc Drugs Ther. 1993;7:357-363.
66. Schönekess BO, Allard MF, Lopaschuk GD. Propionyl L-carnitine improvement of hypertrophied heart function is accompanied by an increase in carbohydrate oxidation. Circ Res. 1995;77:726-734.
67. Micheletti R, Giacalone G, Bianchi G. Effect of propionyl-L-carnitine on the mechanics of right and left papillary muscles from volume-overloaded rat hearts. J Cardiovasc Pharmacol. 1996;27:52-57.
68. Mingorance C, Gonzalez del Pozo M, Dolores Herrera M, Alvarez de Sotomayor M. Oral supplementation of propionyl-l-carnitine reduces body weight and hyperinsulinaemia in obese Zucker rats. Br J Nutr. 2009;102:1145-1153.
69. Mister M, Noris M, Szymczuk J, etal. Propionyl-L-carnitine prevents renal function deterioration due to ischemia/reperfusion. Kidney Int. 2002;61:1064-1078.
70. Azzollini N, Cugini D, Cassis P, etal. Propionyl-L-carnitine prevents early graft dysfunction in allogeneic rat kidney transplantation. Kidney Int. 2008;74:1420-1428.
71. Gómez-Amores L, Mate A, Revilla E, Santa-María C, Vázquez CM. Antioxidant activity of propionyl-L-carnitine in liver and heart of spontaneously hypertensive rats. Life Sci. 2006;78:1945-1952.
72. Al-Majed AA, Sayed-Ahmed MM, Al-Yahya AA, Aleisa AM, Al-Rejaie SS, Al-Shabanah OA. Propionyl-L-carnitine prevents the progression of cisplatin-induced cardiomyopathy in a carnitine-depleted rat model. Pharmacol Res. 2006;53:278-286.
73. Al-Majed AA. Carnitine deficiency provokes cisplatin-induced hepatotoxicity in rats. Basic Clin Pharmacol Toxicol. 2007;100:145-150.
74. Aleisa AM, Al-Majed AA, Al-Yahya AA, etal. Reversal of cisplatin-induced carnitine deficiency and energy starvation by propionyl-L-carnitine in rat kidney tissues. Clin Exp Pharmacol Physiol. 2007;34:1252-1259.
75. Criqui MH, Denenberg JO. The generalized nature of atherosclerosis: how peripheral arterial disease may predict adverse events from coronary artery disease. Vasc Med. 1998;3:241-245.
76. Silvestro A, Scopacasa F, Ruocco A, etal. Inflammatory status and endothelial function in asymptomatic and symptomatic peripheral arterial disease. Vasc Med. 2003;8:225-232.
77. Brevetti G, Silvestro A, Di Giacomo S, etal. Endothelial dysfunction in peripheral arterial disease is related to increase in plasma markers of inflammation and severity of peripheral circulatory impairment but not to classic risk factors and atherosclerotic burden. J Vasc Surg. 2003;38:374-379.
78. Loffredo L, Marcoccia A, Pignatelli P, etal. Oxidative-stress-mediated arterial dysfunction in patients with peripheral arterial disease. Eur Heart J. 2007;28:608-612.
79. Brevetti G, Perna S, Sabbá C, Martone VD, Condorelli M. Propionyl-L-carnitine in intermittent claudication: double-blind, placebo-controlled, dose titration, multicenter study. J Am Coll Cardiol. 1995;26:1411-1416.
80. Brevetti G, Perna S, Sabba C, Martone VD, Di Iorio A, Barletta G. Effect of propionyl-L-carnitine on quality of life in intermittent claudication. Am J Cardiol. 1997;79:777-780.
81. Brevetti G, Diehm C, Lambert D. European multicenter study on propionyl-L-carnitine in intermittent claudication. J Am Coll Cardiol. 1999;34:1618-1624.
82. Hiatt WR, Regensteiner JG, Creager MA, etal. Propionyl-L-carnitine improves exercise performance and functional status in patients with claudication. Am J Med. 2001;110:616-622.
83. Santo SS, Sergio N, Luigi DP, etal. Effect of PLC on functional parameters and oxidative profile in type 2 diabetes-associated PAD. Diabetes Res Clin Pract. 2006;72:231-237.
84. Andreozzi GM. Propionyl l-carnitine: intermittent claudication and peripheral arterial disease. Expert Opin Pharmacother. 2009;10:2697-2707.
85. Andreozzi GM, Leone A, Laudani R, Martin R, Deinit G, Cataldi V. Levo-propionyl-carnitine improves the effectiveness of supervised physical training on the absolute claudication distance in patients with intermittent claudication. Angiology. 2008;59:84-89.
86. Milio G, Novo G, Genova C, Luigi Almasio P, Novo S, Pinto A. Pharmacological treatment of patients with chronic critical limb ischemia: L-propionyl-carnitine enhances the short-term effects of PGE-1. Cardiovasc Drugs Ther. 2009;23:301-306.
87. Bolognesi M, Amodio P, Merkel C, Godi L, Gatta A. Effect of 8-day therapy with propionyl-L-carnitine on muscular and subcutaneous blood flow of the lower limbs in patients with peripheral arterial disease. Clin Physiol. 1995;15:417-423.
88. Cittanti C, Colamussi P, Giganti M, etal. Technetium-99m sestamibi leg scintigraphy for non-invasive assessment of propionyl-L-carnitine induced changes in skeletal muscle metabolism. Eur J Nucl Med. 1997;24:762-766.
89. Dal Lago A, De Martini D, Flore R, etal. Effects of propionyl-L-carnitine on peripheral arterial obliterative disease of the lower limbs: a double-blind clinical trial. Drugs Exp Clin Res. 1999;25:29-36.
90. Signorelli SS, Fatuzzo P, Rapisarda F, etal. A randomised, controlled clinical trial evaluating changes in therapeutic efficacy and oxidative parameters after treatment with propionyl L-carnitine in patients with peripheral arterial disease requiring haemodialysis. Drugs Aging. 2006;23:263-270.
91. Signorelli SS, Fatuzzo P, Rapisarda F, etal. Propionyl-L-carnitine therapy: effects on endothelin-1 and homocysteine levels in patients with peripheral arterial disease and end-stage renal disease. Kidney Blood Press Res. 2006;29:100-107.
92. Loffredo L, Pignatelli P, Cangemi R, etal. Imbalance between nitric oxide generation and oxidative stress in patients with peripheral arterial disease: effect of an antioxidant treatment. J Vasc Surg. 2006;44:525-530.
93. Stasi MA, Scioli MG, Arcuri G, etal. Propionyl-L-carnitine improves postischemic blood flow recovery and arteriogenetic revascularization and reduces endothelial NADPH-oxidase 4-mediated superoxide production. Arterioscler Thromb Vasc Biol. 2010;30:426-435.
94. Hiatt WR, Wolfel EE, Regensteiner JG, Brass EP. Skeletal muscle carnitine metabolism in patients with unilateral peripheral arterial disease. J Appl Physiol. 1992;73:346-353.
95. Corsico N, Nardone A, Lucreziotti MR, etal. Effect of propionyl-L-carnitine in a rat model of peripheral arteriopathy: a functional, histologic, and NMR spectroscopic study. Cardiovasc Drugs Ther. 1993;7:241-251.
96. Taylor DJ, Amato A, Hands LJ, etal. Changes in energy metabolism of calf muscle in patients with intermittent claudication assessed by 31P magnetic resonance spectroscopy: a phase II open study. Vasc Med. 1996;1:241-245.
97. Bartels GL, Remme WJ, Pillay M, etal. Acute improvement of cardiac function with intravenous L-propionylcarnitine in humans. J Cardiovasc Pharmacol. 1992;20:157-164.
98. Bartels GL, Remme WJ, Pillay M, Schönfeld DH, Kruijssen DA. Effects of L-propionylcarnitine on ischemia-induced myocardial dysfunction in men with angina pectoris. Am J Cardiol. 1994;74:125-130.
99. Bartels GL, Remme WJ, Holwerda KJ, Kruijssen DA. Anti-ischaemic efficacy of L-propionylcarnitine - a promising novel metabolic approach to ischaemia? Eur Heart J. 1996;17:414-420.
100. Lagioia R, Scrutinio D, Mangini SG, etal. Propionyl-L-carnitine: a new compound in the metabolic approach to the treatment of effort angina. Int J Cardiol. 1992;34:167-172.
101. Lango R, Smoleński RT, Rogowski J, etal. Propionyl-L-carnitine improves hemodynamics and metabolic markers of cardiac perfusion during coronary surgery in diabetic patients. Cardiovasc Drugs Ther. 2005;19:267-275.
102. Anand I, Chandrashekhan Y, De Giuli F, etal. Acute and chronic effects of propionyl-L-carnitine on the hemodynamics, exercise capacity, and hormones in patients with congestive heart failure. Cardiovasc Drugs Ther. 1998;12:291-299.
103. Opasich C, Pasini E, Aquilani R, etal. Skeletal muscle function at low work level as a model for daily activities in patients with chronic heart failure. Eur Heart J. 1997;18:1626-1631.
104. Caponnetto S, Canale C, Masperone MA, Terracchini V, Valentini G, Brunelli C. Efficacy of L-propionyl-carnitine treatment in patients with left ventricular dysfunction. Eur Heart J. 1994;15:1267-1273.
105. Mancini M, Rengo F, Lingetti M, Sorrentino GP, Nolfe G. Controlled study on the therapeutic efficacy of propionyl-L-carnitine in patients with congestive heart failure. Arzneimittelforschung. 1992;42:1101-1104.
106. Study on propionyl-L-carnitine in chronic heart failure. Eur Heart J. 1999;20:70-76.
107. Gentile V, Vicini P, Prigiotti G, Koverech A, Di Silverio F. Preliminary observations on the use of propionyl-L-carnitine in combination with sildenafil in patients with erectile dysfunction and diabetes. Curr Med Res Opin. 2004;20:1377-1384.
108. Cavallini G, Modenini F, Vitali G, Koverech A. Acetyl-L-carnitine plus propionyl-L-carnitine improve efficacy of sildenafil in treatment of erectile dysfunction after bilateral nerve-sparing radical retropubic prostatectomy. Urology. 2005;66:1080-1085.
109. Cavallini G, Caracciolo S, Vitali G, Modenini F, Biagiotti G. Carnitine versus androgen administration in the treatment of sexual dysfunction, depressed mood, and fatigue associated with male aging. Urology. 2004;63:641-646.
110. Gentile V, Antonini G, Antonella Bertozzi M, etal. Effect of propionyl-L-carnitine, L-arginine and nicotinic acid on the efficacy of vardenafil in the treatment of erectile dysfunction in diabetes. Curr Med Res Opin. 2009;25:2223-2228.
111. Cavallini G, Biagiotti G, Koverech A, Vitali G. Oral propionyl-l-carnitine and intraplaque verapamil in the therapy of advanced and resistant Peyronie's disease. BJU Int. 2002;89:895-900.
112. Safarinejad MR, Hosseini SY, Kolahi AA. Comparison of vitamin E and propionyl-L-carnitine, separately or in combination, in patients with early chronic Peyronie's disease: a double-blind, placebo controlled, randomized study. J Urol. 2007;178:1398-1403.
113. Morano S, Mandosi E, Fallarino M, etal. Antioxidant treatment associated with sildenafil reduces monocyte activation and markers of endothelial damage in patients with diabetic erectile dysfunction: a double-blind, placebo-controlled study. Eur Urol. 2007;52:1768-1774.