Affiliations: Lancisi Heart Institute, Department of Cardiology and
Cardiac Surgery, Ancona, Italy | Clinical Chemistry Lab, Umberto I° Hospital,
Ancona, Italy | Institute of Biochemistry, Polytechnic University of
the Marche, Ancona, Italy
Note: [] Address for correspondence: Romualdo Belardinelli, MD, FESC,
Lancisi Heart Institute, Via Conca, 71, Torrette di Ancona, Italy. Tel.: +39 71
596 5344; Fax: +39 71 36819; E-mail: r.belardinelli@fastnet.it
Abstract: 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.
