Mortensen S A, Vadhanavikit S, Muratsu K, Folkers K
Medical Department B, University Hospital, Copenhagen, Denmark.
Int J Tissue React. 1990;12(3):155-62.
There are obviously several causes of myocardial dysfunction but energy deficiency of the myocytes may play a significant role and probably is a common mechanism during the progression of myocardial failure. Theoretically, a poor utilization efficiency of oxygen may be due to exhaustion of the myocardial stores of bioenergetics. In this report the authors review their biochemical results from measurements of coenzyme Q10 (CoQ10) levels in blood and human endomyocardial biopsies using an HPLC method from patients with suspected myocardial disease (n = 45). The levels of CoQ10, which has a key role in the respiratory chain and the synthesis of ATP, was found to be significantly decreased in various groups of patients with myocardial failure (dilated and restrictive cardiomyopathy and alcoholic heart disease) as compared to "normal" myocardium (0.42 +/- 0.04 micrograms/mg dry weight). The deficiency of CoQ10 was more pronounced with increasing symptoms; e.g. patients with dilated cardiomyopathy in NYHA Classes III and IV had lower tissue CoQ10 content than those of Classes I and II (0.28 +/- 0.04 vs. 0.37 +/- 0.06 micrograms/mg, p less than 0.001). Nearly two thirds of a series of 40 patients in severe heart failure (Classes III and IV) treated with CoQ10, 100 mg daily, in an open, controlled design showed subjective and objective improvement. Clinical responders were 69% and 43% of patients with cardiomyopathy and ischaemic heart disease, respectively. The results suggest that CoQ10 is a novel and effective breakthrough in heart-failure therapy and it appears safe, as no adverse reactions were registered. The through in heart-failure therapy and it appears safe, as no adverse reactions were registered.(ABSTRACT TRUNCATED AT 250 WORDS)
心肌功能障碍显然有多种病因，但心肌细胞能量缺乏可能起重要作用，且很可能是心肌衰竭进展过程中的一个常见机制。理论上，氧利用效率低下可能是由于心肌生物能储备耗竭所致。在本报告中，作者回顾了他们使用高效液相色谱法对疑似心肌病患者（n = 45）血液和人内心肌活检组织中辅酶Q10（CoQ10）水平进行测量的生化结果。在呼吸链和ATP合成中起关键作用的CoQ10水平，在各类心肌衰竭患者（扩张型和限制型心肌病以及酒精性心脏病）中与“正常”心肌相比（0.42±0.04微克/毫克干重）显著降低。CoQ10缺乏随着症状加重而更明显；例如，纽约心脏协会（NYHA）心功能分级III级和IV级的扩张型心肌病患者组织CoQ10含量低于I级和II级患者（0.28±0.04对0.37±0.06微克/毫克，p<0.001）。在一项开放对照设计中，对40例重度心力衰竭（心功能分级III级和IV级）患者每日给予100毫克CoQ10治疗，近三分之二的患者显示主观和客观症状改善。心肌病和缺血性心脏病患者的临床有效率分别为69%和43%。结果表明，CoQ10是心力衰竭治疗中的一项新的有效突破，且似乎是安全的，因为未记录到不良反应。（摘要截选至250字）
