The Effect of Coenzyme Q10 on Idiopathic Chronic Dilated Cardiomyopathy in Children

Abstract

The objective of this study was to assess the effect of coenzyme Q10 (CoQ10) as supplementation to conventional antifailure drugs on quality of life and cardiac function in children with chronic heart failure due to dilated cardiomyopathy (DCM). The study was an open-label prospective study performed in two of the largest pediatric centers in Thailand from August 2000 to June 2003. A total of 15 patients with idiopathic chronic DCM were included, with the median age of 4.4 years (range, 0.6-16.3). Presenting symptoms were congestive heart failure in 12 cases (80%), cardiogenic shock in 2 cases (13.3%), and cardiac arrhythmia in 1 case (6.7%). Sixty-one percent of patients were in the New York Heart Association functional class 2 (NYHA 2), 31% in NYHA 3, and 8% in NYHA 4. Cardiothoracic ratio from chest x-ray, left ventricular ejection fraction, and left ventricular end diastolic dimension in echocardiogram were 0.62 (range, 0.55-0.78), 30% (range, 20-40), and 5.2 cm (range, 3.8-6.5), respectively. CoQ10 was given at a dosage of 3.1 ? 0.6 mg/kg/day for 9 months as a supplementation to a fixed amount of conventional antifailure drugs throughout the study. At follow-up periods of 1, 3, 6, and 9 months, NYHA functional class was significantly improved, as was CT ratio and QRS duration at 3 and 9 months follow-up with CoQ10 when compared to the baseline and post-discontinuation of CoQ10 at 9 months (range, 4.8-10.8). However, when multiple comparisons were taken into consideration, there was no statistical significant improvement. In addition to the conventional antifailure drugs, CoQ10 may improve NYHA class and CT ratio and shorten ventricular depolarization in children with chronic idiopathic DCM.

Coenzyme Q10: Clinical Applications in Cardiovascular Diseases

“…In children with dilated cardiomyopathy, CoQ 10 may improve the cardiothoracic ratio and shorten ventricular depolarization and NYHA class [122]. In a prospective RCT (duration 6 months) in children with dilated cardiomyopathy, the administration of CoQ 10 resulted in a lower mean score for the index of cardiac failure (p < 0.024 compared to placebo) and in improvement of diastolic function (p < 0.011 compared to placebo) [123].…”

Current Experience in Testing Mitochondrial Nutrients in Disorders Featuring Oxidative Stress and Mitochondrial Dysfunction: Rational Design of Chemoprevention Trials

“…A recent review has focused on the multiple implications of CoQ10 deficiency and of CoQ10 administration encompassing an extensive number of disorders [ 100 ]. Out of 101 reports on clinical trials testing CoQ10, 39 studies were focused on support to patients with heart and vessel disorders or undergoing heart surgery [ 11 , 12 , 81 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 , 118 , 119 , 120 , 121 , 122 , 123 , 124 , 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 , 133 , 134 , 135 , 136 ], including 32 controlled studies, as shown in Table 2 . The pioneering studies by the groups of Tanaka [ 11 ] and of Langsjoen [ 12 ] since 1982 provided the avenue for a number of clinical trials assessing the successful outcomes of CoQ10 administration to patients with coronary artery disease, cardiomyopathy, heart failure, or heart surgery, with an overall SR = 0.89.…”

Coenzyme Q10 and congestive heart failure; an evolving evidence base

“…They measured symptoms, ejection fraction, left ventricular size, and quality of life measurements before and after treatment with CoQ 10 . Although they show dramatic improvements, severe study design flaws have limited their applicability [28][29][30][31][32][33][34][35].…”