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Perspectives on therapy of cardiovascular diseases with oenzyme Q10 (Ubiquinone)

  • Conference on Coenzyme Q
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Summary

A defective myocardial energy supply —due to lack of substrates and/or essential cofactors and a poor utilization efficiency of oxygen 3- may be a common final pathway in the progression of myocardial diseases of various etiologies. The vitamin-like essential substance coenzyme Q10, or ubiquinone, is a natural antioxidant and has a key role in oxidative phosphorylation. A biochemical rationale for using coenzyme Q10 as a therapy in heart disease was established years ago by Folkers and associates; however, this has been further strengthened by investigations of viable myocardial tissue from the author's series of 45 patients with various cardiomyopathies. Myocardial tissue levels of coenzyme Q10 determined by high-performance lipid chromatography were found to be significantly lower in patients with more advanced heart failure compared with those in the milder stages of heart failure. Furthermore, the myocardial tissue coenzyme Q10 deficiency might be restored significantly by oral supplementation in selected cases. In the author's open clinical protocol study with coenzyme Q10 therapy (100 mg daily) nearly two-thirds of patients revealed clinical improvement, most pronounced in those with dilated cardiomyopathy. Double-blind placebo-controlled trials have definitely confirmed that coenzyme Q10 has a place as adjunctive treatment in heart failure with beneficial effects on the clinical outcome, the patients' physical activity, and their quality of life. The positive results have been above and beyond the clinical status obtained from treatment with traditional principles — including angiotensin-converting enzyme inhibitors.

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Abbreviations

CoQ10 :

coenzyme Q10

NYHA:

New York Heart Association

LV-EF%:

left ventricular ejection fraction

References

  1. Beyer RE, Ernster L (1990) The antioxidant role of coenzyme Q. In: Lenaz G, Barnabei O, Rabbi A, Battino A (eds) Highlights in ubiquinone research. Taylor & Francis, London, pp 191–213

    Google Scholar 

  2. Bristow MR, Ginsburg R, Minobe W, Cubicciotti RS, Scott Sageman W, Lurie K, Billingham ME, Harrison DC, Stinson WB (1982) Decreased catecholamine sensitivity and beta-adrenergic-receptor density in failing human hearts. New Engl J Med 307:205–211

    Google Scholar 

  3. Captopril-digoxin multicenter research group (1988) Comparative effects with captopril and digoxin in patients with mild-to-moderate heart failure. JAMA 259:539–544

    Google Scholar 

  4. Cortes EP, Gupta M, Chou C, Patel M, Mundia A, Folkers K (1977) Study of administration of coenzyme Q10 to Adriamycin treated cancer patients. In: Folkers K, Yamamura Y (eds) Biomedical and clinical aspects of coenzyme Q, vol. 5. Elsevier, Amsterdam, pp 267–278

    Google Scholar 

  5. Folkers K, Littarru GP, Ho L, Runge TM, Havanonda S, Cooley D (1970) Evidence for a deficiency of coenzyme Q10 in human heart disease. Int J Vit Nutr Res 40:380–390

    Google Scholar 

  6. Folkers K, Vadhanavikit S, Mortensen SA (1985) Biochemical rationale and myocardial tissue data on the effective therapy of cardiomyopathy with coenzyme Q10. Proc Natl Acad Sci USA 82:901–904

    Google Scholar 

  7. Hofman-Bang C, Rehnquist N, Swedberg K for the Q10 Study Group (1992) coenzyme Q10 as an adjunctive treatment of congestive heart failure. J Am Coll Cardiol 19:216A

    Google Scholar 

  8. Judy WV, Hall JH, Toth PD, Folkers K (1986) Double blind-double crossover study of coenzyme Q10 in heart failure. In: Folkers K, Yamamura Y (eds) Biomedical and clinical aspects of coenzyme Q, vol. 5. Elsevier, Amsterdam, pp 315–323

    Google Scholar 

  9. Kamikawa T, Kobayashi A, Yamashita T, Hayashi H, Yamazaki N (1985) Effects of coenzyme Q-10 on exercise tolerance in chronic stable angina pectoris. Am J Cardiol 56:247–251

    Google Scholar 

  10. Katz A (1987) Cellular mechanisms in congestive heart failure. International Symposium on Advances in Congestive Heart Failure. Olso, Norway, March 27–28, 1987

  11. Kawai C, Yui Y, Hoshino T, Sasayama S, Matsumori A (1983) Myocardial cathecolamines in hypertrophic and dilated (congestive) cardiomyopathy: a biopsy study. J Am Coll Cardiol 2:834–840

    Google Scholar 

  12. Kondrup J, Mortensen SA (1989) Endomyocardial levels of free and total carnitine in patients with cardiomyopathy. Heart Failure 5:37–40

    Google Scholar 

  13. Langsjoen PH, Vadhanavikit S, Folkers K (1985) Response of patients in classes III and IV of cardiomyopathy to therapy in a blind and crossover trial with coenzyme Q10. Proc Natl Acad Sci USA 82:4240–4244

    Google Scholar 

  14. Lenaz G, Degli Esposti M (1985) Physical properties of ubiquinones in model systems and membranes. In: Lenaz G (ed) Coenzyme Q. Wiley, Chichester, pp 83–105

    Google Scholar 

  15. Lin L. Sotonyi P, Somogyi E, Karlsson J, Folkers K, Nara Y, Sylrén C, Kaijser L, Jansson E (1988) Coenzyme Q10 content in different parts of the normal human heart. Clin Physiol 8:391–398

    Google Scholar 

  16. Mortensen SA (1989) Thesis: endomyocardial biopsy. Technical aspects and indications. Dan Med Bull 36:507–532

    Google Scholar 

  17. Mortensen SA, Bouchelouche PN, Muratsu K, Folkers K (1986) Clinical decline and relapse of cardiac patients on withdrawal of coenzyme Q10. In: Folkers K, Yamamura Y (eds) Biomedical and clinical aspects of coenzyme Q, vol 5. Elsevier, Amsterdam, pp 281–290

    Google Scholar 

  18. Mortensen SA, Vadhanavikit S, Baandrup U, Folkers K (1985) Long-term coenzyme Q10 therapy: a major advance in the management of resistant myocardial failure. Drugs Exp Clin Res 11:581–593

    Google Scholar 

  19. Nayler WG (1980) The use of coenzyme Q-10 to protect ischemic heart muscle. In: Yamamura Y, Folkers K, Ito Y (eds) Biomedical and clinical aspects of coenzyme Q, vol 5. Elsevier, Amsterdam, pp 409–425

    Google Scholar 

  20. Ohhara H, Kanaide H, Nakamura M (1981) A protective effect of coenzyme Q-10 on the Adriamycin-induced cardiotoxicity in the isolated perfused rabbit heart. J Mol Cell Cardiol 13:741–752

    Google Scholar 

  21. Permanetter B, Rossy W, Weingartner F, Bauer R, Seidl KF, Klein G (1989) Fehlende Wirksamkeit von Coenzym Q10 (Ubichinon) bei der Langzeitbehandlung der dilatativen Kardiomyopathie. Z Kardiol 78:360–365

    Google Scholar 

  22. Permanetter B, Rossy W, Klein G, Weingartner F, Seidl KF, Blomer H (1992) Ubiquinone (coenzyme Q10) in the long-term treatment of idiopathic dilated cardiomyopathy. Eur Heart J 13:1528–1533

    Google Scholar 

  23. Peters TJ, Wells G, Oakley CM, Brooksby JAB, Jenkins BS, Webb-Pebloe MM, Coltart DJ (1977) Enzymic analysis of endomyocardial biopsy specimens from patients with cardiomyopathies. Br Heart J 39:1333–1339

    Google Scholar 

  24. Schardt F, Welzel D, Schiess W, Toda K (1986) Effect of coenzyme Q10 on ischaemia-induced ST-segment depression: a doubleblind, placebo-controlled crossover study. In: Folkers K, Yamamura Y (eds) Biomedical and clinical aspects of coenzyme Q, vol 5. Elsevier, Amsterdam, pp 385–394

    Google Scholar 

  25. Schultheiss, HP, Bolte HD, Cyran J (1980) Lactate dehydrogenase isoenzyme pattern in myocardial biopsies of patients with congestive cardiomyopathy and with alcoholic cardiomyopathy — clinical and experimental results. In: Bolte HD (ed) Myocardial biopsy. Springer, Berlin Heidelberg New York, pp 102–115

    Google Scholar 

  26. Sunamori M, Okamura T, Amano J, Suzuki A (1984) Clinical application of coenzyme Q to coronary artery bypass graft surgery. In: Folkers K, Yamamura Y (eds) Biomedical and clinical aspects of coenzyme Q, vol 4. Elsevier, Amsterdam, pp 333–342

    Google Scholar 

  27. Tanaka J, Tominaga R, Yoshitoshi M, et al (1982) Coenzyme Q10: the prophylactic effect on low cardiac output following cardiac valve replacement. Ann Thorac Surg 33:145–151

    Google Scholar 

  28. The CONSENSUS Trial Study Group (1987) Effects of enalapril on mortality in severe congestive heart failure: results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med 316:1429–1435

    Google Scholar 

  29. Vadhanavikit S, Morishita M, Duff GA, Folkers K (1984) Micro-analysis for coenzyme Q10 in endomyocardial biopsies of cardiac patients and data on bovine and canine hearts. Biochem Biophys Res Commun 123:1165–1169

    Google Scholar 

  30. Wilson MF, Frishman WH, Giles T, Sethi G, Greenberg SM, Brackett DJ (1991) Coenzyme Q10 therapy and exercise duration in stable angina. In: Folkers K, Littarru GP, Yamagami T (eds) Biomedical and clinical aspects of coenzyme Q, vol 6. Elsevier, Amsterdam, pp 339–348

    Google Scholar 

  31. Yamagami T, Takagi M, Akagami H, et al (1986) Effect of coenzyme Q10 on essential hypertension, a double-blind controlled study. In: Folkers K, Yamamura Y (eds) Biomedical and clinical aspects of coenzyme Q, vol 5. Elsevier, Amsterdam, pp 337–343

    Google Scholar 

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Mortensen, S.A. Perspectives on therapy of cardiovascular diseases with oenzyme Q10 (Ubiquinone). Clin Investig 71 (Suppl 8), S116–S123 (1993). https://doi.org/10.1007/BF00226851

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