Coenzyme Q10 improves contractility of dysfunctional myocardium in chronic heart failure.
BACKGROUND
There is evidence that plasma CoQ(10) levels decrease in patients with advanced chronic heart failure (CHF).


OBJECTIVE
To investigate whether oral CoQ(10) supplementation could improve cardiocirculatory efficiency in patients with CHF.


METHODS
We studied 21 patients in NYHA class II and III (18M, 3W, mean age 59 +/- 9 years) with stable CHF secondary to ischemic heart disease (ejection fraction 37 +/- 7%), using a double-blind, placebo-controlled cross-over design. Patients were assigned to oral CoQ(10) (100 mg tid) and to placebo for 4 weeks, respectively.


RESULTS
CoQ(10) supplementation resulted in a threefold increase in plasma CoQ(10) level (P < 0.0001 vs placebo). Systolic wall thickening score index (SWTI) was improved both at rest and peak dobutamine stress echo after CoQ(10) supplementation (+12.1 and 15.6%, respectively, P < 0.05 vs placebo). Left ventricular ejection fraction improved significantly also at peak dobutamine (15% from study entry P < 0.0001) in relation to a decrease in LV end-systolic volume index (from 57 +/- 7 mL/m(2) to 45 mL/m(2), P < 0.001). Improvement in the contractile response was more evident among initially akinetic (+33%) and hypokinetic (+25%) segments than dyskinetic ones (+6%). Improvement in SWTI was correlated with changes in plasma CoQ(10) levels (r = -0.52, P < 0.005). Peak VO(2) was also improved after CoQ(10) as compared with placebo (+13%, <0.005). No side effects were reported with CoQ(10).


CONCLUSIONS
Oral CoQ(10) improves LV contractility in CHF without any side effects. This improvement is associated with an enhanced functional capacity.
Belardinelli
Romualdo
R
Lancisi Heart Institute, Department of Cardiology and Cardiac Surgery, Ancona, Italy. r.belardinelli@fastnet.it
Muçaj
Andi
A
Lacalaprice
Francesca
F
Solenghi
Maridia
M
Principi
Federica
F
Tiano
Luca
L
Littarru
Gian Paolo
GP
D000368:Aged; D002303:Cardiac Output, Low / Q000188:drug therapy* / Q000503:physiopathology; D002908:Chronic Disease / Q000188:drug therapy; D003067:Coenzymes; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects*; D014451:Ubiquinone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016277:Ventricular Function, Left / Q000187:drug effects
D003067:Coenzymes; D014451:Ubiquinone; C024989:coenzyme Q10