Coenzyme Q10 in the Treatment of Heart Failure with Preserved Ejection Fraction: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial

Abstract

Background Heart failure with preserved ejection fraction (HFpEF) is common in elderly people and is increasing in prevalence. No specific treatment for this condition exists. Coenzyme Q10 (CoQ10) is an essential cofactor for energy production, with reduced levels being noted in HF. Previous studies have suggested a possible role for CoQ10 in the treatment of HF. This study examined the effect of CoQ10 supplementation on diastolic function in HFpEF patients. Methods We conducted a prospective, randomized, double-blind, placebo-controlled trial including patients aged > 55 years presenting with New York Heart Association class II-IV heart failure symptoms and left ventricular ejection fraction > 50%, with impaired diastolic function. Echocardiography and levels of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) were performed at baseline and following 4 months of CoQ10 or placebo supplementation. Results A total of 39 patients were enrolled-19 in the CoQ10 group and 20 in the placebo group. Baseline clinical characteristics were similar between groups, while compliance was high and also similar between the CoQ10 and placebo groups. There was no significant effect of treatment on indices of diastolic function (difference in the lateral E/e' ratio: −0.86 ± 6.57 in the CoQ10 group, +0.18 ± 3.76 in the placebo group; p = 0.561) or on serum NT-proBNP levels (− 72 pg/mL vs. − 42 pg/mL; p = 0.195). Conclusions In this pilot trial in elderly patients with HFpEF, treatment with CoQ10 did not significantly affect echocardiographic indices of diastolic function and serum NT-proBNP levels. Trial Registration This trial was registered in the US National Institutes of Health Clinical Trials Registry (ClinicalTrials. gov identifier: NCT02779634).

Comparison of Coenzyme Q10 (Ubiquinone) and Reduced Coenzyme Q10 (Ubiquinol) as Supplement to Prevent Cardiovascular Disease and Reduce Cardiovascular Mortality

“…In contrast to that, CoQH2 studies included test concentrations between 300 and 600 mg/day. The only CoQH2 study using 300 mg/ day test concentration included only 39 patients, and no beneficial cardiovascular effects could be observed [42].…”

Ferroptosis: The Potential Target in Heart Failure with Preserved Ejection Fraction

“…However, current studies on CoQ10 improving myocardial diastolic function have shown conflicting results. Adarsh et al [ 81 ] showed that CoQ10 significantly improved exercise tolerance and diastolic dysfunction in patients with hypertrophic cardiomyopathy, but no positive results were shown in two other studies [ 82 , 83 ]. This may be due to differences in the diastolic function assessment criteria and biologic agents (ubiquinone and ubiquinone alcohol) that led to changes in bioavailability [ 84 ]; thus, the effectiveness of CoQ10 needs further confirmation.…”

Promising directions in the treatment of chronic heart failure: improving old or developing new ones?

“…Примечание ремоделирование и функциональное состояние ЛЖ, а также снижение риска смерти и повторных госпитализаций [1,12,131,132]. Продолжается разработка и клиническое тестирование потенциально эффективных при ХСН миокардиальных цитопротекторов, направленных на торможение окисления жирных кислот, стимуляцию окисления глюкозы, активцию цитохромной цепи, оптимизацию транспорта энергетического субстрата в митохондрии, а также повышение антиоксидантного потенциала кардиомиоцита [4,[133][134][135][136][137][138][139][140][141][142][143] Коррекция гиперкалиемии, которая классифицируется как легкая (5,0-5,4 ммоль/л), умеренная (5,5-6,0 ммоль/л) и тяжелая (>6,0 ммоль/л).…”