INHIBITION OF APOPTOSIS OF SKELETAL MUSCLE FIBERS IN HEART FAILURE AS A THERAPEUTICAL TOOL TO ANTAGONIZE MUSCLE ATROPHY

Heart failure is a high mortality disease. Patients with CHF have troublesome symptoms that make their life very often unacceptable. We have discovered that the majority of these symptoms such as fatigue and shortness of breath, originate in the skeletal muscle. In fact the muscle become, atrophic, weak and easily fatigable. Patients stop exercising because their leg cannot put up with the effort. The muscle become atrophic because the fibres that constitute it, die spontaneously. This way of dying is called apoptosis, or programmed cell death. We have also discovered that the sufferance of the muscle and its death can be cured with drugs commonly available in the market for the treatment of another cardiovascular diseases. Patients treated with these drugs live longer, and tolerate effort in a much better fashion. Their muscles become stronger, more trophic and put up better with exercise. In this study we want to see whether a substance which is naturally contained in our muscles and that has been shown to have favourable metabolic effects, but can also at the same time block those mechanisms that lead to programmed myocyte death, can protect the muscle from deterioration. This substance is called carnitine. We have the hope that carnitine can favourably work on the muscle of patients with CHF with improvement of those symptoms rendering quality of life better.