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Q10 en chronisch hartfalen

Coenzyme Q10 and chronic heart failure

Chronic heart failure (CHF) is on the rise. The connection between CHF, coenzyme Q-10 (CoQ- 10) and statins is discussed frequently outside of mainstream medicine since statins inhibit the synthetic pathway for the endogenous synthesis of this enzyme.

A study has just been reported in the Journal of the American College of Cardiology which investigated the relationship between CoQ-10 and survival in patients with CHF. It was found that plasma CoQ-10 was an independent predictor of mortality in a group of 236 patients admitted to hospital with CHF.
When a cut-point of 0.73 micromol/L was used, the group above this plasma level had approximately a 65% 5-year survival whereas for those below this level, it was 40%.

The authors comment that there had been previously reported an independent inverse association between plasma cholesterol and total mortality and that the myocardium in patients with heart failure is deficient in CoQ-10.
The authors cite 12 clinical studies which suggest benefits from CoQ-10 supplementation.

In a meta-analysis of 8 studies, it was found that CoQ-10 supplementation significantly improved stroke volume, ejection fraction, cardiac output, and two other indices of cardiac function.
Another meta-analysis found improvements in ejection fraction and cardiac output.

Some of these studies may underestimate the benefits of CoQ-10 supplementation in that there are considerable differences in bioavailability (biologische beschikbaarheid)among various formulations of this enzyme.
The authors also comment that a multicenter intervention trial of CoQ-10 as an adjunctive treatment for CHF is underway which is randomized and double blind. However, examination of the description of the trial fails to reveal the nature of the enzyme preparation, only the dose which is 300 mg.

Since bioavailability can vary by a factor of 2 or 3, this may be an issue when it comes to interpreting the results, i.e. was the dose high enough?

Molyneux SL, et al. Coenzyme Q10: An independent predictor of mortality in chronic heart failure. Journal of the American College of Cardiology, Vol. 52, No. 18, October 28, 2008, pp. 1435-41

Lisa
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Re:Q10 en chronisch hartfalen

Statins + coenzyme Q10 may benefit heart failure patients

WUHAN CITY, CHINA.
There is now growing evidence that oxidative stress and inflammation are involved in chronic heart failure.
Statin drugs such as atorvastatin, simvastatin and pravastatin have recently been shown to posses anti-inflammatory properties and coenzyme Q10 is a powerful antioxidant and essential for cardiac mitochondrial energy production.

Unfortunately, statin drugs reduce the level of coenzyme Q10, sometimes to the point of fostering muscle-related problems (myopathies) like rhabdomyolysis.

A team of Chinese researchers at Wuhan University has now come up with the idea of combining the statin drug atorvastatin (Lipitor) with coenzyme Q10 in the treatment of patients with congestive heart failure. (goh, nou ja, beter laat dan nooit? ;)

They conducted a clinical trial in which heart failure patients on standard treatment were randomized into receiving atorvastatin, coenzyme Q10, atorvastatin + Q10, or a placebo.

At the end of the 6-month treatment period the following changes were observed:

The level of the inflammatory marker C-reactive protein (CRP) had dropped from 5.5 mg/L (0.55 mg/dL) to 2.0 mg/L in the atorvastatin + coenzyme Q10 group. Levels of the inflammatory marker tumor necrotic factor alpha and the oxidative stress marker malondialdehyde also dropped significantly in the atorvastatin + Q10 group.

Left ventricular ejection fraction had increased from 30% to 43% in the atorvastatin + Q10 group.

No significant changes were observed in the control group.

The Chinese researchers conclude that atorvastatin and coenzyme Q10 act synergistically to improve heart failure symptoms. They emphasize that the addition of Q10 serves to increase Q10 levels depleted by the illness as well as to counter the negative influence of statin drugs on Q10 levels.

Other researchers have found that coenzyme Q10, [i]on its own[/i], is highly beneficial in that it improves cardiac systolic function by enhancing the production of ATP (adenosine triphosphate) and reducing oxidative stress.

Okello, E, et al. Combined statin/coenzyme Q10 as adjunctive treatment of chronic heart failure. Medical Hypotheses, 2009 [Epub ahead of print]

Editor's comment (bij dit artikel, en te lezen op:
http://www.oilofpisces.com/coenzyme_Q10news.htm )
Combining a statin drug with coenzyme Q10 for the treatment of heart failure is clearly beneficial. However, there are many more effective and far less dangerous natural anti-inflammatories. Thus, a combination of turmeric and Q10 might well prove to be a very effective therapy for chronic heart failure.