The Influence of Atorvastatin, Amlodipine and Ethoxidol on Ubiquinol and Ubiquinone Endogenous Plasma Concentrations in Patients with Chronic Heart Failure

BACKGROUND

Coenzyme Q10 is a key component of the mitochondrial respiratory chain and a fat-soluble endogenous antioxidant performing many vital functions in the human body. Many researchers studied the plasma concentrations of ubiquinol, ubiquinone, total CoQ10 and the redox state (ubiquinol/ubiquinone ratio) of CoQ10 in healthy volunteers. However, these parameters in the plasma of patients with chronic heart failure (CHF) remain almost uninvestigated.

OBJECTIVE

The aim of this case-control study was to investigate the effect of atorvastatin, amlodipine and ethoxidol on endogenous plasma concentrations of ubiquinol, ubiquinone, total CoQ10 and its redox state in patients with CHF.

METHODS

The study included 62 patients with CHF divided into four groups depending on the prescribed therapy. For the quantitative determination of ubiquinol, ubiquinone, and total CoQ10 in the plasma of patients, HPLCMS/ MS was used.

RESULTS

It was established that the endogenous plasma concentration of total CoQ10 in patients with CHF is significantly lower than in healthy volunteers, and the ratio of reduced and oxidized forms of CoQ10 is shifted towards ubiquinone. It was a statistically significant effect of drugs with different physicochemical structures and pharmacological action on the plasma concentrations of ubiquinol, ubiquinone and total CoQ10: atorvastatin administration led to a decrease in the concentration of ubiquinol (-33.3Δ%), and total CoQ10 (-15Δ%), administration of amlodipine contributed to an increase in the levels of ubiquinol (+27.7Δ%) and total CoQ10 (+18.2Δ%), and the administration of ethoxidol caused an increase in the concentration of ubiquinol (+25Δ%), ubiquinone (+17.7Δ%) and total CoQ10 (+20.2Δ%).

CONCLUSION

Amlodipine is able to neutralize the negative effect of atorvastin on the redox balance of CoQ10 in patients with CHF. An additional prescription of the antioxidant ethoxidol to standard therapy for patients with CHF was substantiated. Determination of the redox state of CoQ10 in plasma can be used to diagnose and assess the degree of oxidative stress in patients with cardiovascular diseases, as well as to assess the efficacy and safety of ongoing pharmacotherapy.

The effect of coenzyme Q10 as a part of standard therapy on plasma concentrations of ubiquinol, ubiquinone, total CoQ10 and its redox state in patients with ischemic heart disease

BACKGROUND

Despite CoQ10 being a powerful antioxidant and its redox state that may characterize the body's antioxidant system, the latter remains unstudied in patients with cardiovascular diseases.

OBJECTIVE

This prospective case-control study aimed to investigate the concentrations of ubiquinol, ubiquinone, total CoQ10 and its redox state in patients with ischemic heart disease (IHD) and arterial hypertension (AH) during standard therapy and with the additional prescription of CoQ10.

METHODS

The study included 54 healthy individuals and 26 patients, who were divided into a control group receiving standard therapy and a test group receiving CoQ10 in addition to standard therapy. Quantitative determination of COQ10, ubiquinone and ubiquinol was carried out by HPLC-MS/MS.

RESULTS

It was found that the CoQ10 level in patients was significantly lower than in healthy individuals (on average -32Δ%). In the test group, after treatment, the concentrations of ubiquinol (+53 Δ%), ubiquinone (-28 Δ%), total CoQ10 (+27 Δ%) and redox state (+112 Δ%) were significantly different from the baseline, while in the control group no significant differences were noticed. In the test group after treatment, the levels of total CoQ10 (+25 Δ%), ubiquinol (+43 Δ%), and redox state (+86 Δ%) were statistically significantly higher than in the control group and total CoQ10 concentration did not significantly differ from that in healthy individuals (-12 Δ%).

CONCLUSION

The additional prescription of CoQ10 for patients with IHD significantly increases the level of total CoQ10, which leads to the increase of body antioxidant potential .

Coenzyme Q10 in COPD: An Unexplored Opportunity?

COPD represents a major cause of mortality and morbidity worldwide, is linked to systemic inflammation and tends to coexist with a variety of comorbidities. Inflammation, oxidative stress and protease-antiprotease imbalance represent the pathogenic triad of COPD. Even though oxidative stress and mitochondrial dysfunction is a well-studied phenomenon in COPD and there is a variety of studies that aim to counteract its effect, there is limited data available on the use of coenzyme Q10 in COPD. The aim of the current review is to analyze the current data on the use of coenzyme Q10 in the management of COPD and frequently encountered comorbidities.

The Mechanism of Action of Ethoxidol on Oxidative Stress Indices in Heart Failure and Hypotension

The aim of the investigation was to study the effect of 2-ethyl-6-methyl-3-hydroxypyridine malate (Ethoxidol) on the concentration of oxidative stress metabolites in patients with chronic heart failure (CHF) and hypertension.

Materials and Methods

126 patients with FC I-III CHF have been examined. In addition to their individual therapy these patients received intravenous infusions of Ethoxidol. Blood content of 2,3-diphosphoglycerate (2,3-DPG), oxygen tension (рО₂), pH, concentration of total peroxides, lactate, and aldosterone were identified. 2,3-DPG levels (g/L erythrocytes) in whole blood samples were determined by an enzyme assay using the reagent kit (Rosh, Germany), values of рО₂, рСО₂, рН, lactate in the venous blood were measured using gas analyzer Stat Profil pHOx Ultra (Nova Biomedical, USA). Indices of oxidative stress, i.e. the concentration of plasma total peroxides, were investigated by ELISA using OxyStat kit (Biomedica, Austria). Peripheral venous blood samples were collected from all patients before and 6 days after the daily intravenous Ethoxidol infusion.

Results

In patients with FC I, II, III CHF, on day 7 after intravenous Ethoxidol infusion at a dose of 100 mg/day, statistically significant growth (p=0.0002) of PaO₂ level by 15.7, 17.4, and 22.8%, respectively, was noted. In patients with FC I, II, III CHF in the group receiving standard therapy, statistically significant (p=0.002) reduction of 2,3-DPG level by 2.7, 2.4, and 4.0%, respectively, was registered. On day 7 after the infusion of Ethoxidol at a dose of 100 mg/day, its decrease by 5.7, 10.5, and 26.2%, respectively (p<0.0001), was also observed.

Conclusion

The increased concentrations of active oxygen forms have been established to negatively affect various bodily functions and adversely influence the pathophysiology of numerous diseases. Application of antioxidants, including Ethoxidol presented by us in this article, may become a clue to the development of preventive measures for many serious diseases.