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Opstad TB, Alexander J, Aaseth JO, Larsson A, Seljeflot I, Alehagen U. Selenium and Coenzyme Q 10 Intervention Prevents Telomere Attrition, with Association to Reduced Cardiovascular Mortality-Sub-Study of a Randomized Clinical Trial. Nutrients 2022; 14:nu14163346. [PMID: 36014852 PMCID: PMC9412367 DOI: 10.3390/nu14163346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/05/2022] [Accepted: 08/12/2022] [Indexed: 11/16/2022] Open
Abstract
Short telomeres have been associated with ageing and cardiovascular disease. The influence on leukocyte telomere length (LTL) of long-term intervention with combined selenium and coenzyme Q10 is unknown. Our aim was to determine whether 42 months of selenium and coenzyme Q10 supplementation prevented telomere attrition and further cardiovascular mortality. The investigation is an explorative sub-study of a double-blind, placebo-controlled, randomized trial. Swedish citizens low in selenium (n = 118), aged 70−80 years, were included. Intervention time was 4 years, with 10 years’ follow-up time. LTL was relatively quantified with PCR at baseline and after 42 months. At baseline, LTL (SD) was 0.954 (0.260) in the active treatment group and 1.018 (0.317) in the placebo group (p = 0.23). At 42 months, less shortening of LTL was observed after active treatment compared with placebo (+0.019 vs. −0.129, respectively, p = 0.02), with a significant difference in change basing the analysis on individual changes in LTL (p < 0.001). Subjects suffering future death presented with significantly shorter LTL at 42 months than survivors [0.791 (0.190) vs. 0.941 (0.279), p = 0.01], with a significant difference in change of LTL according to cardiovascular mortality and survival (p = 0.03). To conclude, preservation of LTL after selenium and coenzyme Q10 supplementation associated with reduced cardiovascular mortality.
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Affiliation(s)
- Trine Baur Opstad
- Centre for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, 0450 Oslo, Norway
- Faculty of Medicine, University of Oslo, 0315 Oslo, Norway
- Correspondence:
| | - Jan Alexander
- Norwegian Institute of Public Health, 0213 Oslo, Norway
| | - Jan O. Aaseth
- Department of Research, Innlandet Hospital Trust, 2381 Brumunddal, Norway
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, 2624 Lillehammer, Norway
| | - Anders Larsson
- Department of Medical Sciences, Uppsala University, 752 36 Uppsala, Sweden
| | - Ingebjørg Seljeflot
- Centre for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, 0450 Oslo, Norway
- Faculty of Medicine, University of Oslo, 0315 Oslo, Norway
| | - Urban Alehagen
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, 581 83 Linköping, Sweden
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Pierce JD, Shen Q, Mahoney DE, Rahman F, Krueger KJ, Diaz FJ, Clark L, Smith C, Vacek J, Hiebert JB. Effects of Ubiquinol and/or D-ribose in Patients With Heart Failure With Preserved Ejection Fraction. Am J Cardiol 2022; 176:79-88. [PMID: 35644694 PMCID: PMC9576187 DOI: 10.1016/j.amjcard.2022.04.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 01/27/2023]
Abstract
Patients with heart failure with preserved ejection fraction (HFpEF) have few pharmacologic therapies, and it is not known if supplementing with ubiquinol and/or d-ribose could improve outcomes. The overall objective of this study was to determine if ubiquinol and/or d-ribose would reduce the symptoms and improve cardiac performance in patients with HFpEF. This was a phase 2 randomized, double-blind, placebo-controlled trial of 216 patients with HFpEF who were ≥ 50 years old with a left ventricular ejection fraction (EF) ≥ 50%. A total of 4 study groups received various supplements over 12 weeks: Group 1 received placebo ubiquinol capsules and d-ribose powder, Group 2 received ubiquinol capsules (600 mg/d) and placebo d-ribose powder, Group 3 received placebo ubiquinol capsules with d-ribose powder (15 g/d), and Group 4 received ubiquinol capsules and d-ribose powder. There were 7 outcome measures for this study: Kansas City Cardiomyopathy Questionnaire (KCCQ) clinical summary score, level of vigor using a subscale from the Profile of Mood States, EF, the ratio of mitral peak velocity of early filling to early diastolic mitral annular velocity (septal E/e' ratio), B-type natriuretic peptides, lactate/adenosine triphosphate ratio, and the 6-minute walk test. Treatment with ubiquinol and/or d-ribose significantly improved the KCCQ clinical summary score (17.30 to 25.82 points), vigor score (7.65 to 8.15 points), and EF (7.08% to 8.03%) and reduced B-type natriuretic peptides (-72.02 to -47.51) and lactate/adenosine triphosphate ratio (-4.32 to -3.35 × 10-4). There were no significant increases in the septal E/e' or the 6-minute walk test. In conclusion, ubiquinol and d-ribose reduced the symptoms of HFpEF and increased the EF. These findings support the use of these supplements in addition to standard therapeutic treatments for patients with HFpEF.
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Affiliation(s)
- Janet D. Pierce
- University of Kansas Medical Center, School of Nursing, Kansas City, Kansas,Corresponding author: Tel: 913 588-1663; fax: 913 588-1660. (J.D. Pierce)
| | - Qiuhua Shen
- University of Kansas Medical Center, School of Nursing, Kansas City, Kansas
| | - Diane E. Mahoney
- University of Kansas Medical Center, School of Nursing, Kansas City, Kansas
| | - Faith Rahman
- University of Kansas Cancer Center, Westwood, Kansas
| | - Kathryn J. Krueger
- University of Kansas Medical Center, School of Nursing, Kansas City, Kansas
| | - Francisco J. Diaz
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, Kansas
| | - Lauren Clark
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, Kansas
| | - Carol Smith
- University of Kansas Medical Center, School of Nursing, Kansas City, Kansas
| | - James Vacek
- University of Kansas Medical Center, School of Medicine, Kansas City, Kansas
| | - John B. Hiebert
- University of Kansas Medical Center, School of Nursing, Kansas City, Kansas
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Heart Failure—Do We Need New Drugs or Have Them Already? A Case of Coenzyme Q10. J Cardiovasc Dev Dis 2022; 9:jcdd9050161. [PMID: 35621872 PMCID: PMC9143244 DOI: 10.3390/jcdd9050161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/08/2022] [Accepted: 05/13/2022] [Indexed: 12/04/2022] Open
Abstract
Heart failure (HF) is a global epidemic that contributes to the deterioration of quality of life and its shortening in 1–3% of adult people in the world. Pharmacotherapy of HF should rely on highly effective drugs that improve prognosis and prolong life. Currently, the ESC guidelines from 2021 indicate that ACEI, ARNI, BB, and SGLT2 inhibitors are the first-line drugs in HF. It is also worth remembering that the use of coenzyme Q10 brought many benefits in patients with HF. Coenzyme Q10 is a very important compound that performs many functions in the human body. The most important function of coenzyme Q10 is participation in the production of energy in the mitochondria, which determines the proper functioning of all cells, tissues, and organs. The highest concentration of coenzyme Q10 is found in the tissue of the heart muscle. As the body ages, the concentration of coenzyme Q10 in the tissue of the heart muscle decreases, which makes it more susceptible to damage by free radicals. It has been shown that in patients with HF, the aggravation of disease symptoms is inversely related to the concentration of coenzyme Q10. Importantly, the concentration of coenzyme Q10 in patients with HF was an important predictor of the risk of death. Long-term coenzyme Q10 supplementation at a dose of 300 mg/day (Q-SYMBIO study) has been shown to significantly improve heart function and prognosis in patients with HF. This article summarizes the latest and most important data on CoQ10 in pathogenesis.
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Preventing Myocardial Injury Following Non-Cardiac Surgery: A Potential Role for Preoperative Antioxidant Therapy with Ubiquinone. Antioxidants (Basel) 2021; 10:antiox10020276. [PMID: 33579045 PMCID: PMC7916807 DOI: 10.3390/antiox10020276] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/05/2021] [Accepted: 02/05/2021] [Indexed: 02/07/2023] Open
Abstract
Over 240 million non-cardiac operations occur each year and are associated with a 15-20% incidence of adverse perioperative cardiovascular events. Unfortunately, preoperative therapies that have been useful for chronic ischemic heart diseases, such as coronary artery revascularization, antiplatelet agents, and beta-blockers have failed to improve outcomes. In a pre-clinical swine model of ischemic heart disease, we showed that daily administration of ubiquinone (coenzyme Q10, CoQ10) enhances the antioxidant status of mitochondria within chronically ischemic heart tissue, potentially via a PGC1α-dependent mechanism. In a randomized controlled trial, among high-risk patients undergoing elective vascular surgery, we showed that NT Pro-BNP levels are an important means of risk-stratification during the perioperative period and can be lowered with administration of CoQ10 (400 mg/day) for 3 days prior to surgery. The review provides background information for the role of oxidant stress and inflammation during high-risk operations and the potential novel application of ubiquinone as a preoperative antioxidant therapy that might reduce perioperative adverse cardiovascular outcomes.
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Martelli A, Testai L, Colletti A, Cicero AFG. Coenzyme Q 10: Clinical Applications in Cardiovascular Diseases. Antioxidants (Basel) 2020; 9:antiox9040341. [PMID: 32331285 PMCID: PMC7222396 DOI: 10.3390/antiox9040341] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/18/2020] [Accepted: 04/20/2020] [Indexed: 02/06/2023] Open
Abstract
Coenzyme Q10 (CoQ10) is a ubiquitous factor present in cell membranes and mitochondria, both in its reduced (ubiquinol) and oxidized (ubiquinone) forms. Its levels are high in organs with high metabolism such as the heart, kidneys, and liver because it acts as an energy transfer molecule but could be reduced by aging, genetic factors, drugs (e.g., statins), cardiovascular (CV) diseases, degenerative muscle disorders, and neurodegenerative diseases. As CoQ10 is endowed with significant antioxidant and anti-inflammatory features, useful to prevent free radical-induced damage and inflammatory signaling pathway activation, its depletion results in exacerbation of inflammatory processes. Therefore, exogenous CoQ10 supplementation might be useful as an adjuvant in the treatment of cardiovascular diseases such as heart failure, atrial fibrillation, and myocardial infarction and in associated risk factors such as hypertension, insulin resistance, dyslipidemias, and obesity. This review aims to summarize the current evidences on the use of CoQ10 supplementation as a therapeutic approach in cardiovascular diseases through the analysis of its clinical impact on patients' health and quality of life. A substantial reduction of inflammatory and oxidative stress markers has been observed in several randomized clinical trials (RCTs) focused on several of the abovementioned diseases, even if more RCTs, involving a larger number of patients, will be necessary to strengthen these interesting findings.
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Affiliation(s)
- Alma Martelli
- Department of Pharmacy, University of Pisa, 56120 Pisa, Italy; (A.M.); (L.T.)
- Interdepartmental Research Centre “Nutraceuticals and Food for Health (NUTRAFOOD)”, University of Pisa, 56120 Pisa, Italy
- Interdepartmental Research Centre of Ageing, Biology and Pathology, University of Pisa, 56120 Pisa, Italy
| | - Lara Testai
- Department of Pharmacy, University of Pisa, 56120 Pisa, Italy; (A.M.); (L.T.)
- Interdepartmental Research Centre “Nutraceuticals and Food for Health (NUTRAFOOD)”, University of Pisa, 56120 Pisa, Italy
- Interdepartmental Research Centre of Ageing, Biology and Pathology, University of Pisa, 56120 Pisa, Italy
| | - Alessandro Colletti
- Department of Science and Drug Technology, University of Turin, 10125 Turin, Italy;
- Italian Nutraceutical Society (SINut), Via Guelfa 9, 40138 Bologna, Italy
| | - Arrigo F. G. Cicero
- Italian Nutraceutical Society (SINut), Via Guelfa 9, 40138 Bologna, Italy
- Medical and Surgical Sciences Department, University of Bologna, 40126 Bologna, Italy
- Correspondence: ; Tel.: +39-512142224
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Nutraceutical support in heart failure: a position paper of the International Lipid Expert Panel (ILEP). Nutr Res Rev 2020; 33:155-179. [PMID: 32172721 DOI: 10.1017/s0954422420000049] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Heart failure (HF) is a complex clinical syndrome that represents a major cause of morbidity and mortality in Western countries. Several nutraceuticals have shown interesting clinical results in HF prevention as well as in the treatment of the early stages of the disease, alone or in combination with pharmacological therapy. The aim of the present expert opinion position paper is to summarise the available clinical evidence on the role of phytochemicals in HF prevention and/or treatment that might be considered in those patients not treated optimally as well as in those with low therapy adherence. The level of evidence and the strength of recommendation of particular HF treatment options were weighed up and graded according to predefined scales. A systematic search strategy was developed to identify trials in PubMed (January 1970 to June 2019). The terms 'nutraceuticals', 'dietary supplements', 'herbal drug' and 'heart failure' or 'left verntricular dysfunction' were used in the literature search. The experts discussed and agreed on the recommendation levels. Available clinical trials reported that the intake of some nutraceuticals (hawthorn, coenzyme Q10, l-carnitine, d-ribose, carnosine, vitamin D, probiotics, n-3 PUFA and beet nitrates) might be associated with improvements in self-perceived quality of life and/or functional parameters such as left ventricular ejection fraction, stroke volume and cardiac output in HF patients, with minimal or no side effects. Those benefits tended to be greater in earlier HF stages. Available clinical evidence supports the usefulness of supplementation with some nutraceuticals to improve HF management in addition to evidence-based pharmacological therapy.
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Khan A, Johnson DK, Carlson S, Hocum-Stone L, Kelly RF, Gravely AA, Mbai M, Green DL, Santilli S, Garcia S, Adabag S, McFalls EO. NT-Pro BNP Predicts Myocardial Injury Post-vascular Surgery and is Reduced with CoQ 10: A Randomized Double-Blind Trial. Ann Vasc Surg 2019; 64:292-302. [PMID: 31629852 DOI: 10.1016/j.avsg.2019.09.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/29/2019] [Accepted: 09/06/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND NT-Pro BNP levels provide incremental value in perioperative risk assessment prior to major noncardiac surgery. Whether they can be pharmacologically modified in patients prior to an elective vascular operation is uncertain. METHODS A double-blind, randomized controlled trial was implemented at a single institution. Patients were screened during their preoperative vascular clinic appointment and randomly assigned to CoQ10 (400 mg per day) versus Placebo for 3 days prior to surgery. Biomarkers, including NT-Pro BNP, troponin I and C-reactive protein were obtained prior to and following surgery for up to 48 hours. The primary endpoint was postoperative NT-Pro BNP levels, and secondary endpoint measures included myocardial injury, defined by an elevated cardiac troponin level and length of stay. RESULTS One hundred and twenty-three patients were randomized to receive either CoQ10 (N = 62) versus Placebo (N = 61) for 3 days before vascular surgery. Preoperative cardiac risks included ischemic heart disease (N = 52), CHF (N = 12), stroke (N = 23), and diabetes mellitus (N = 48) and the planned vascular procedures were infrainguinal (N = 78), carotid (N = 36), and intraabdominal (N = 9). There were no intergroup differences in these clinical variables. NT-Pro BNP levels (median; IQs) in the CoQ10 and Placebo groups were 179 (75-347) and 217 (109-585) pg/ml, respectively, (P = 0.08) preoperatively, and 397 (211-686) and 591 (288-1,433) pg/ml respectively, (P = 0.01) at 24 hours following surgery. Patients with an elevated NT-Pro BNP had a higher incidence of myocardial injury, (58% vs. 20%; P < 0.01) and a longer hospital stay (4.4 ± 3.8 vs. 2.8 ± 3.2 days; P < 0.02) compared with individuals without an elevated NT-Pro BNP level. CONCLUSIONS NT-Pro BNP levels predict adverse events post-vascular surgery and are lowered in those patients assigned to preoperative administration of CoQ10. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT03956017. Among patients undergoing elective vascular surgery, 123 patients were randomized to either CoQ10 (400 mg/day) versus placebo for three days preoperatively. NT-Pro BNP levels (median; IQs) in the CoQ10 and Placebo groups were 179 (75-347) and 217 (109-585) pg/ml, respectively, (P = 0.08) preoperatively, and 397 (211-686) and 591 (288-1,433) pg/ml, respectively, (P = 0.01) post-surgery. Patients with an elevated NT-Pro BNP had a higher incidence of myocardial injury (58% vs. 20%; P < 0.01) and a longer hospital stay (4.4 ± 3.8 vs. 2.8 ± 3.2 days; P < 0.02) compared with individuals without an NT-Pro BNP elevation. In conclusion, BNP predicts adverse outcomes and can be reduced with preoperative CoQ10.
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Affiliation(s)
- Asrar Khan
- Division of Cardiology, University of Minnesota, Minneapolis, MN
| | - Debra K Johnson
- Division of Cardiology, Minneapolis VA Medical Center, Minneapolis, MN
| | - Selma Carlson
- Division of Cardiology, University of Minnesota, Minneapolis, MN; Division of Cardiology, Minneapolis VA Medical Center, Minneapolis, MN
| | - Laura Hocum-Stone
- Division of Cardiology, Minneapolis VA Medical Center, Minneapolis, MN; Division of Cardiothoracic Surgery, University of Minnesota, Minneapolis, MN
| | - Rosemary F Kelly
- Division of Cardiothoracic Surgery, University of Minnesota, Minneapolis, MN
| | - Amy A Gravely
- Department of Research Statistical Center, Minneapolis VA Medical Center, Minneapolis, MN
| | - Mackenzi Mbai
- Division of Cardiology, University of Minnesota, Minneapolis, MN; Division of Cardiology, Minneapolis VA Medical Center, Minneapolis, MN
| | - Derrick L Green
- Division of Vascular Surgery, Minneapolis VA Medical Center, Minneapolis, MN
| | - Steve Santilli
- Division of Vascular Surgery, Minneapolis VA Medical Center, Minneapolis, MN
| | - Santiago Garcia
- Division of Cardiology, Minneapolis Heart Institute, Minneapolis, MN
| | - Selcuk Adabag
- Division of Cardiology, University of Minnesota, Minneapolis, MN; Division of Cardiology, Minneapolis VA Medical Center, Minneapolis, MN
| | - Edward O McFalls
- Division of Cardiology, University of Minnesota, Minneapolis, MN; Division of Cardiology, Minneapolis VA Medical Center, Minneapolis, MN.
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Kloer HU, Belardinelli R, Ruchong O, Rosenfeldt F. Combining Ubiquinol With a Statin May Benefit Hypercholesterolaemic Patients With Chronic Heart Failure. Heart Lung Circ 2019; 29:188-195. [PMID: 31668616 DOI: 10.1016/j.hlc.2019.08.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 07/01/2019] [Accepted: 08/16/2019] [Indexed: 12/17/2022]
Abstract
Heart failure (HF) is one of the most common causes of death in Western society. Recent results underscore the utility of coenzyme Q10 (CoQ10) addition to standard medications in order to reduce mortality and to improve quality of life and functional capacity in chronic heart failure (CHF). The rationale for CoQ10 supplementation in CHF is two-fold. One is the well-known role of CoQ10 in myocardial bioenergetics, and the second is its antioxidant property. Redox balance is also improved by oral supplementation of CoQ10, and this effect contributes to enhanced endothelium-dependent relaxation. Previous reports have shown that CoQ10 concentration is decreased in myocardial tissue in CHF and by statin therapy, and the greater the CoQ10 deficiency the more severe is the cardiocirculatory impairment. In patients with CHF and hypercholesterolaemia being treated with statins, the combination of CoQ10 with a statin may be useful for two reasons: decreasing skeletal muscle injury and improving myocardial function. Ubiquinol, the active reduced form of CoQ10, presents higher bioavailability than the oxidised form ubiquinone, and should be the preferred form to be added to a statin. The combination ezetimibe/simvastatin may have advantages over single statins. Since ezetimibe reduces absorption of cholesterol and does not affect CoQ10 synthesis in the liver, the impact of this combination on CoQ10 tissue levels will be much less than that of high dose statin monotherapy at any target low density lipoprotein-cholesterol (LDL-C) level to be reached. This consideration makes the ezetimibe/statin combination the ideal LDL-lowering agent to be combined with ubiquinol in CHF patients. However, particular caution is advisable with the use of strategies of extreme lowering of cholesterol that may negatively impact on myocardial function. All in all there is a strong case for considering co-administration of ubiquinol with statin therapy in patients with depressed or borderline myocardial function.
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Affiliation(s)
- Hans-Ulrich Kloer
- Emer, Third Medical Department, UKGM, University of Giessen, Germany
| | | | - Ou Ruchong
- Baker Heart and Diabetes Institute, Melbourne, Vic, Australia; Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Vic, Australia
| | - Franklin Rosenfeldt
- Baker Heart and Diabetes Institute, Melbourne, Vic, Australia; Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Vic, Australia.
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Dragan S, Buleu F, Christodorescu R, Cobzariu F, Iurciuc S, Velimirovici D, Xiao J, Luca CT. Benefits of multiple micronutrient supplementation in heart failure: A comprehensive review. Crit Rev Food Sci Nutr 2018; 59:965-981. [PMID: 30507249 DOI: 10.1080/10408398.2018.1540398] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Multiple micronutrient supplementation has been suggested to have a role on health outcomes in patients with heart failure (HF), but the evidence is inconclusive. OBJECTIVE To elucidate the role of multiple micronutrient supplementation in heart failure we performed a comprehensive review of the literature. METHODS AND RESULTS The search in databases included PUBMED (until June 2018) to detect randomized controlled trials (RCTs) and meta-analyzes that investigated the impact of micronutrient supplementation in HF. RESULTS With more than 2357 titles and abstracts reviewed, we included only the studies suitable for the final review. Whether alone or in combination, micronutrients have been found to improve the health outcomes of patients with HF by improving symptoms, work capacity and left ventricular ejection fraction (LVEF), thus increasing the quality of life in these patients. CONCLUSION Future studies are needed to document the effects of multiple micronutrient associations in order to include them in nutritional guidelines to increase survival and to improve quality of life in patients with heart failure.
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Affiliation(s)
- Simona Dragan
- a Department of Cardiology, Discipline of Preventive Cardiology , "Victor Babes" University of Medicine and Pharmacy , Timisoara , Romania
| | - Florina Buleu
- a Department of Cardiology, Discipline of Preventive Cardiology , "Victor Babes" University of Medicine and Pharmacy , Timisoara , Romania
| | - Ruxandra Christodorescu
- b Department of Internal Medicine, Discipline of Medical Semiology II , "Victor Babes" University of Medicine and Pharmacy , Timisoara , Romania
| | - Florin Cobzariu
- a Department of Cardiology, Discipline of Preventive Cardiology , "Victor Babes" University of Medicine and Pharmacy , Timisoara , Romania
| | - Stela Iurciuc
- a Department of Cardiology, Discipline of Preventive Cardiology , "Victor Babes" University of Medicine and Pharmacy , Timisoara , Romania
| | - Dana Velimirovici
- a Department of Cardiology, Discipline of Preventive Cardiology , "Victor Babes" University of Medicine and Pharmacy , Timisoara , Romania
| | - Jianbo Xiao
- c Institute of Chinese Medical Sciences , University of Macau , Taipa , China
| | - Constantin Tudor Luca
- d Department of Cardiology, Discipline of Cardiology II , "Victor Babes" University of Medicine and Pharmacy , Timisoara , Romania
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Chen FL, Chang PS, Lin YC, Lin PT. A Pilot Clinical Study of Liquid Ubiquinol Supplementation on Cardiac Function in Pediatric Dilated Cardiomyopathy. Nutrients 2018; 10:nu10111697. [PMID: 30405022 PMCID: PMC6266971 DOI: 10.3390/nu10111697] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 10/25/2018] [Accepted: 11/05/2018] [Indexed: 11/24/2022] Open
Abstract
Background: Pediatric dilated cardiomyopathy (PDCM) is a life-threatening type of cardiac muscle dysfunction in children. Ubiquinone is a lipid-soluble nutrient that participates in energy synthesis. Recently, a novel hydrophilic ubiquinol supplement was developed. The purpose of this study was to assess the effect of liquid ubiquinol supplementation (10 mg/kg body weight/day) on cardiac function in children with PDCM. Methods: Ten children diagnosed with PDCM were recruited to this study and administered with liquid ubiquinol for 24 weeks. The cardiac function was measured by echocardiography. The New York Heart Association (NYHA) functional classification was used to assess symptoms of heart failure. Plasma coenzyme Q10 levels were measured during the study. Results: Ejection fraction (EF) and fractional shortening (FS) were significantly higher than the baseline values until week 16 of supplementation. Subjects who had higher plasma coenzyme Q10 concentration had significantly better EF and FS values. In addition, 30% of the subjects showed improvement in the NYHA classification after 24 weeks of supplementation. Conclusion: Liquid ubiquinol supplementation is associated with an increase the level of coenzyme Q10 to complementary improve cardiac function (particularly EF and FS) and ameliorate the symptoms of heart failure in children with PDCM.
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Affiliation(s)
- Fong-Lin Chen
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
- School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
- Pediatric Cardiology Clinic, Taichung 40244, Taiwan.
| | - Po-Sheng Chang
- Department of Nutrition, Chung Shan Medical University, Taichung 40201, Taiwan.
- Graduate Program in Nutrition, Chung Shan Medical University, Taichung 40201, Taiwan.
| | - Yi-Chin Lin
- Department of Nutrition, Chung Shan Medical University, Taichung 40201, Taiwan.
| | - Ping-Ting Lin
- Department of Nutrition, Chung Shan Medical University, Taichung 40201, Taiwan.
- Department of Nutrition, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
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Still reduced cardiovascular mortality 12 years after supplementation with selenium and coenzyme Q10 for four years: A validation of previous 10-year follow-up results of a prospective randomized double-blind placebo-controlled trial in elderly. PLoS One 2018; 13:e0193120. [PMID: 29641571 PMCID: PMC5894963 DOI: 10.1371/journal.pone.0193120] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 01/29/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Selenium and coenzyme Q10 are both necessary for optimal cell function in the body. The intake of selenium is low in Europe, and the endogenous production of coenzyme Q10 decreases as age increases. Therefore, an intervention trial using selenium and coenzyme Q10 for four years as a dietary supplement was performed. The main publication reported reduced cardiovascular mortality as a result of the intervention. In the present sub-study the objective was to determine whether reduced cardiovascular (CV) mortality persisted after 12 years, in the supplemented population or in subgroups with diabetes, hypertension, ischemic heart disease or reduced functional capacity due to impaired cardiac function. METHODS From a rural municipality in Sweden, four hundred forty-three healthy elderly individuals were included. All cardiovascular mortality was registered, and no participant was lost to the follow-up. Based on death certificates and autopsy results, mortality was registered. FINDINGS After 12 years a significantly reduced CV mortality could be seen in those supplemented with selenium and coenzyme Q10, with a CV mortality of 28.1% in the active treatment group, and 38.7% in the placebo group. A multivariate Cox regression analysis demonstrated a reduced CV mortality risk in the active treatment group (HR: 0.59; 95%CI 0.42-0.81; P = 0.001). In those with ischemic heart disease, diabetes, hypertension and impaired functional capacity we demonstrated a significantly reduced CV mortality risk. CONCLUSIONS This is a 12-year follow-up of a group of healthy elderly participants that were supplemented with selenium and coenzyme Q10 for four years. Even after twelve years we observed a significantly reduced risk for CV mortality in this group, as well as in subgroups of patients with diabetes, hypertension, ischemic heart disease or impaired functional capacity. The results thus validate the results obtained in the 10-year evaluation. The protective action was not confined to the intervention period, but persisted during the follow-up period. The mechanisms behind this effect remain to be fully elucidated, although various effects on cardiac function, oxidative stress, fibrosis and inflammation have previously been identified. Since this was a small study, the observations should be regarded as hypothesis-generating. TRIAL REGISTRATION Clinicaltrials.gov NCT01443780.
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Gutierrez-Mariscal FM, Yubero-Serrano EM, Villalba JM, Lopez-Miranda J. Coenzyme Q10: From bench to clinic in aging diseases, a translational review. Crit Rev Food Sci Nutr 2018; 59:2240-2257. [DOI: 10.1080/10408398.2018.1442316] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Francisco M. Gutierrez-Mariscal
- Lipid and Atherosclerosis Unit, Department of Internal Medicine/IMIBIC/Reina Sofia University Hospital/University of Córdoba, Córdoba, Spain; CIBER Fisiología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Elena M. Yubero-Serrano
- Lipid and Atherosclerosis Unit, Department of Internal Medicine/IMIBIC/Reina Sofia University Hospital/University of Córdoba, Córdoba, Spain; CIBER Fisiología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Jose M. Villalba
- Departamento de Biología Celular, Fisiología e Inmunología, Universidad de Córdoba, Campus de Excelencia Internacional Agroalimentario, ceiA3, Córdoba, Spain
| | - Jose Lopez-Miranda
- Lipid and Atherosclerosis Unit, Department of Internal Medicine/IMIBIC/Reina Sofia University Hospital/University of Córdoba, Córdoba, Spain; CIBER Fisiología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
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Cicero AF, Colletti A. Food and plant bioactives for reducing cardiometabolic disease: How does the evidence stack up? Trends Food Sci Technol 2017. [DOI: 10.1016/j.tifs.2017.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Rivara MB, Yeung CK, Robinson-Cohen C, Phillips BR, Ruzinski J, Rock D, Linke L, Shen DD, Ikizler TA, Himmelfarb J. Effect of Coenzyme Q 10 on Biomarkers of Oxidative Stress and Cardiac Function in Hemodialysis Patients: The CoQ 10 Biomarker Trial. Am J Kidney Dis 2017; 69:389-399. [PMID: 27927588 PMCID: PMC5616172 DOI: 10.1053/j.ajkd.2016.08.041] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 08/25/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND Oxidative stress is highly prevalent in patients with end-stage renal disease and is linked to excess cardiovascular risk. Identifying therapies that reduce oxidative stress has the potential to improve cardiovascular outcomes in patients undergoing maintenance dialysis. STUDY DESIGN Placebo-controlled, 3-arm, double-blind, randomized, clinical trial. SETTING & PARTICIPANTS 65 patients undergoing thrice-weekly maintenance hemodialysis. INTERVENTION Patients were randomly assigned in a 1:1:1 ratio to receive once-daily coenzyme Q10 (CoQ10; 600 or 1,200mg) or matching placebo for 4 months. OUTCOMES The primary outcome was plasma oxidative stress, defined as plasma concentration of F2-isoprotanes. Secondary outcomes included levels of plasma isofurans, levels of cardiac biomarkers, predialysis blood pressure, and safety/tolerability. MEASUREMENTS F2-isoprostanes and isofurans were measured as plasma markers of oxidative stress, and N-terminal pro-brain natriuretic peptide and troponin T were measured as cardiac biomarkers at baseline and 1, 2, and 4 months. RESULTS Of 80 randomly assigned patients, 15 were excluded due to not completing at least 1 postbaseline study visit and 65 were included in the primary intention-to-treat analysis. No treatment-related major adverse events occurred. Daily treatment with 1,200mg, but not 600mg, of CoQ10 significantly reduced plasma F2-isoprostanes concentrations at 4 months compared to placebo (adjusted mean changes of -10.7 [95% CI, -7.1 to -14.3] pg/mL [P<0.001] and -8.3 [95% CI, -5.5 to -11.0] pg/mL [P=0.1], respectively). There were no significant effects of CoQ10 treatment on levels of plasma isofurans, cardiac biomarkers, or predialysis blood pressures. LIMITATIONS Study not powered to detect small treatment effects; difference in baseline characteristics among randomized groups. CONCLUSIONS In patients undergoing maintenance hemodialysis, daily supplementation with 1,200mg of CoQ10 is safe and results in a reduction in plasma concentrations of F2-isoprostanes, a marker of oxidative stress. Future studies are needed to determine whether CoQ10 supplementation improves clinical outcomes for patients undergoing maintenance hemodialysis.
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Affiliation(s)
- Matthew B Rivara
- Kidney Research Institute, Seattle, WA; Division of Nephrology, Department of Medicine, University of Washington, Seattle, WA
| | - Catherine K Yeung
- Kidney Research Institute, Seattle, WA; Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA
| | - Cassianne Robinson-Cohen
- Kidney Research Institute, Seattle, WA; Division of Nephrology, Department of Medicine, University of Washington, Seattle, WA
| | - Brian R Phillips
- Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, WA
| | | | | | | | - Danny D Shen
- Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA; Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, WA
| | - T Alp Ikizler
- Division of Nephrology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Jonathan Himmelfarb
- Kidney Research Institute, Seattle, WA; Division of Nephrology, Department of Medicine, University of Washington, Seattle, WA.
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Liu S, Wang P, Shen PP, Zhou JH. Predictive Values of Red Blood Cell Distribution Width in Assessing Severity of Chronic Heart Failure. Med Sci Monit 2016; 22:2119-25. [PMID: 27324271 PMCID: PMC4920102 DOI: 10.12659/msm.898103] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background This retrospective study was performed to evaluate the value of baseline red blood cell distribution width (RDW) for predicting the severity of chronic heart failure (CHF) compared with N-terminal prohormone brain natriuretic peptide (NT-ProBNP) and other hematological and biochemical parameters. Material/Methods Hematological and biochemical parameters were obtained from 179 patients with New York Heart Association (NYHA) CHF class I (n=44), II (n=39), III (n=41), and IV (n=55). Receiver operator characteristic (ROC) curves were used for assessing predictive values. Results RDW increased significantly in class III and IV compared with class I (14.3±2.3% and 14.3±1.7% vs. 12.9±0.8%, P<0.01). Areas under ROCs (AUCs) of RDW and NT-ProBNP for class IV HF were 0.817 and 0.840, respectively. RDW was markedly elevated in the mortality group compared with the survival group (13.7±1.7 vs. 15.8±1.8, P<0.01). The predictive value of RDW was lower than that of NT-ProBNP but was comparable to white blood cell (WBC), neutrophil (NEU), lymphocyte (L), and neutrophil/lymphocyte ratio (N/L) for mortality during hospitalization, with AUCs of 0.837, 0.939, 0.858, 0.891, 0.885, and 0.885, respectively. RDW and NT-proBNP showed low predictive values for repeated admission (≥3). RDW was an independent risk factor for mortality (OR=2.531, 95% CI: 1.371–4.671). Conclusions RDW increased significantly in class III and IV patients and in the mortality group. The predictive value of RDW is comparable to NT-proBNP for class IV and lower than that of NT-proBNP for mortality. Elevated RDW is an independent risk factor for mortality.
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Affiliation(s)
- Sen Liu
- Department of Cardiology, Affiliated Weihai Central Hospital of Weifang Medical College, Wendeng, Shandong, China (mainland)
| | - Ping Wang
- Department of Cardiology, Affiliated Weihai Central Hospital of Weifang Medical College, Wendeng, Shandong, China (mainland)
| | - Ping-Ping Shen
- Department of Cardiology, Affiliated Weihai Central Hospital of Weifang Medical College, Wendeng, Shandong, China (mainland)
| | - Jian-Hua Zhou
- Department of Cardiology, Affiliated Weihai Central Hospital of Weifang Medical College, Wendeng, Shandong, China (mainland)
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Reduced Cardiovascular Mortality 10 Years after Supplementation with Selenium and Coenzyme Q10 for Four Years: Follow-Up Results of a Prospective Randomized Double-Blind Placebo-Controlled Trial in Elderly Citizens. PLoS One 2015; 10:e0141641. [PMID: 26624886 PMCID: PMC4666408 DOI: 10.1371/journal.pone.0141641] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 10/12/2015] [Indexed: 01/08/2023] Open
Abstract
Background Selenium and coenzyme Q10 are important antioxidants in the body. As the intake of selenium is low in Europe, and the endogenous production of coenzyme Q10 decreases as age increases, an intervention trial using selenium and coenzyme Q10 for four years was performed. As previously reported, the intervention was accompanied by reduced cardiovascular mortality. The objective of the present study was to analyze cardiovascular mortality for up to 10 years after intervention, to evaluate if mortality differed in subgroups differentiated by gender, diabetes, ischemic heart disease (IHD), and functional class. Methods Four-hundred forty-three healthy elderly individuals were included from a rural municipality in Sweden. All cardiovascular mortality was registered, and no participant was lost to the follow-up. Based on death certificates and autopsy results mortality was registered. Findings Significantly reduced cardiovascular mortality could be seen in those on selenium and coenzyme Q10 intervention. A multivariate Cox regression analysis demonstrated a reduced cardiovascular mortality risk in the active treatment group (HR: 0.51; 95%CI 0.36–0.74; P = 0.0003). The reduced mortality could be seen to persist during the 10-year period. Subgroup analysis showed positive effects in both genders. An equally positive risk reduction could be seen in those with ischemic heart disease (HR: 0.51; 95%CI 0.27–0.97; P = 0.04), but also in the different functional classes. Conclusions In a 10-year follow-up of a group of healthy elderly participants given four years of intervention with selenium and coenzyme Q10, significantly reduced cardiovascular mortality was observed. The protective action was not confined to the intervention period, but persisted during the follow-up period. The mechanism explaining the persistency remains to be elucidated. Since this was a small study, the observations should be regarded as hypothesis-generating.
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Onur S, Niklowitz P, Fischer A, Jacobs G, Lieb W, Laudes M, Menke T, Döring F. Determination of the coenzyme Q10 status in a large Caucasian study population. Biofactors 2015; 41:211-21. [PMID: 26228113 DOI: 10.1002/biof.1216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 05/22/2015] [Indexed: 11/11/2022]
Abstract
Coenzyme Q10 (CoQ10 ) exists in a reduced (ubiquinol) and an oxidized (ubiquinone) form in all human tissues and functions, amongst others, in the respiratory chain, redox-cycles, and gene expression. As the status of CoQ10 is an important risk factor for several diseases, here we determined the CoQ10 status (ubiquinol, ubiquinone) in a large Caucasian study population (n = 1,911). The study population covers a wide age range (age: 18-83 years, 43.4% men), has information available on more than 10 measured clinical phenotypes, more than 30 diseases (presence vs. absence), about 30 biomarkers, and comprehensive genetic information including whole-genome SNP typing (>891,000 SNPs). The major aim of this long-term resource in CoQ10 research is the comprehensive analysis of the CoQ10 status with respect to integrated health parameters (i.e., fat metabolism, inflammation), disease-related biomarkers (i.e., liver enzymes, marker for heart failure), common diseases (i.e., neuropathy, myocardial infarction), and genetic risk in humans. Based on disease status, biomarkers, and genetic variants, our cohort is also useful to perform Mendelian randomisation approaches. In conclusion, the present study population is a promising resource to gain deeper insight into CoQ10 status in human health and disease.
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Affiliation(s)
- Simone Onur
- Division of Molecular Prevention, Institute of Human Nutrition and Food Science, Christian Albrechts University Kiel, Kiel, 24118, Germany
| | - Petra Niklowitz
- Children's Hospital of Datteln, University of Witten/Herdecke, 45711, Datteln, Germany
| | - Alexandra Fischer
- Division of Molecular Prevention, Institute of Human Nutrition and Food Science, Christian Albrechts University Kiel, Kiel, 24118, Germany
| | - Gunnar Jacobs
- Institute of Epidemiology and Biobank Popgen, Christian Albrechts University Kiel, Campus University Hospital Schleswig-Holstein, 24105, Kiel, Germany
| | - Wolfgang Lieb
- Institute of Epidemiology and Biobank Popgen, Christian Albrechts University Kiel, Campus University Hospital Schleswig-Holstein, 24105, Kiel, Germany
| | - Matthias Laudes
- Department of Internal Medicine, University Hospital Schleswig-Holstein, 24105, Kiel, Germany
| | - Thomas Menke
- Children's Hospital of Datteln, University of Witten/Herdecke, 45711, Datteln, Germany
| | - Frank Döring
- Division of Molecular Prevention, Institute of Human Nutrition and Food Science, Christian Albrechts University Kiel, Kiel, 24118, Germany
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