Coenzyme Q10 in patients with end-stage heart failure awaiting cardiac transplantation: a randomized, placebo-controlled study.
BACKGROUND
The number of patients awaiting heart transplantation is increasing in proportion to the waiting period for a donor. Studies have shown that coenzyme Q10 (CoQ10) has a beneficial effect on patients with heart failure.


OBJECTIVE
The purpose of the present double-blind, placebo-controlled, randomized study was to assess the effect of CoQ10 on patients with end-stage heart failure and to determine if CoQ10 can improve the pharmacological bridge to heart transplantation.


METHODS
A prospective double-blind design was used. Thirty-two patients with end-stage heart failure awaiting heart transplantation were randomly allocated to receive either 60 mg U/day of Ultrasome--CoQ10 (special preparation to increase intestinal absorption) or placebo for 3 months. All patients continued their regular medication regimen. Assessments included anamnesis with an extended questionnaire based partially on the Minnesota Living with Heart Failure Questionnaire, 6-min walk test, blood tests for atrial natriuretic factor (ANF) and tumor necrosis factor (TNF), and echocardiography.


RESULTS
Twenty-seven patients completed the study. The study group showed significant improvement in the 6-min walk test and a decrease in dyspnea, New York Heart Association (NYHA) classification, nocturia, and fatigue. No significant changes were noted after 3 months of treatment in echocardiography parameters (dimensions and contractility of cardiac chambers) or ANF and TNF blood levels.


CONCLUSIONS
The administration of CoQ10 to heart transplant candidates led to a significant improvement in functional status, clinical symptoms, and quality of life. However, there were no objective changes in echo measurements or ANF and TNF blood levels. Coenzyme Q10 may serve as an optional addition to the pharmacologic armamentarium of patients with end-stage heart failure. The apparent discrepancy between significant clinical improvement and unchanged cardiac status requires further investigation.
Berman
Marius
M
Department of Cardiothoracic Surgery, Heart-Lung Transplant Unit, Rabin Medical Center, Beilinson Campus, Potah Tikva, Israel. mariusby@yahoo.com
Erman
Arie
A
Ben-Gal
Tuvia
T
Dvir
Dan
D
Georghiou
Georgios P
GP
Stamler
Alon
A
Vered
Yaffa
Y
Vidne
Bernardo A
BA
Aravot
Dan
D
D000328:Adult; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D003067:Coenzymes; D004311:Double-Blind Method; D017079:Exercise Tolerance; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy*; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D014451:Ubiquinone / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D014463:Ultrasonography; D014850:Waiting Lists
D002316:Cardiotonic Agents; D003067:Coenzymes; D014409:Tumor Necrosis Factor-alpha; D014451:Ubiquinone; D009320:Atrial Natriuretic Factor; C024989:coenzyme Q10