Manzoli U, Rossi E, Littarru G P, Frustaci A, Lippa S, Oradei A, Aureli V
Institute of Cardiology, Catholic University, Rome, Italy.
Int J Tissue React. 1990;12(3):173-8.
The authors have tried to study the therapeutic efficacy of coenzyme Q10 (CoQ10) in patients with dilated cardiomyopathy (DCM). In fact, CoQ10 has been shown to be deficient in myocardial tissue biopsies taken from DCM hearts, compared to normal hearts. Thirty patients with histological diagnosis of DCM were orally treated with CoQ10 (100 mg/die) for 2 months. Before and after treatment a clinical examination with determination of NYHA class and an echocardiographic examination with determination of ejection fraction (EF) and of telediastolic (TDV) and telesystolic (TSV) volumes were performed, and blood was drawn for plasma CoQ10 determination. In seven patients the pretreatment endomyocardial level of CoQ10 was also assayed. Seven patients left the study because of poor therapeutic compliance. In 47% of patients the clinical symptomatology regressed, with improvement of NYHA class. The EF improved from 0.31 +/- 0.09 to 0.37 +/- 0.11 (p less than 0.001). The TDV passed from 262.2 +/- 85 ml to 203.3 +/- 83 ml (p less than 0.05), and the TSV from 166.13 +/- 75 ml to 126.9 +/- 56 ml (ns). The CoQ10 plasmatic levels improved in 95% of the patients: from 0.74 +/- 0.37 micrograms/ml to 2.27 +/- 0.99 micrograms/ml (p +/- 0.0001). The CoQ10 myocardial levels did not show univocal values, but the patients with lower myocardial levels seemed to have a better therapeutic response. These data suggest that the CoQ10 deficiency in DCM may be reversible and that the therapeutic effects depend on the basal plasmatic and myocardial levels. Therapy with coenzyme Q10 may be considered to be an efficacious aid in the traditional treatment of chronic cardiac failure.
作者试图研究辅酶Q10（CoQ10）对扩张型心肌病（DCM）患者的治疗效果。事实上，与正常心脏相比，从DCM心脏获取的心肌组织活检显示CoQ10缺乏。30例经组织学诊断为DCM的患者口服CoQ10（100mg/日）治疗2个月。治疗前后进行了临床检查以确定纽约心脏协会（NYHA）心功能分级，并进行了超声心动图检查以测定射血分数（EF）、舒张末期容积（TDV）和收缩末期容积（TSV），同时抽取血液测定血浆CoQ10水平。对7例患者还测定了治疗前心肌内CoQ10水平。7例患者因治疗依从性差退出研究。47%的患者临床症状消退，NYHA心功能分级改善。EF从0.31±0.09提高到0.37±0.11（p＜0.001）。TDV从262.2±85ml降至203.3±83ml（p＜0.05），TSV从166.13±75ml降至126.9±56ml（无统计学意义）。95%的患者血浆CoQ10水平升高：从0.74±0.37μg/ml升至2.27±0.99μg/ml（p＜0.0001）。CoQ10心肌水平无明确一致的值，但心肌水平较低的患者似乎有更好的治疗反应。这些数据表明DCM中的CoQ10缺乏可能是可逆的，且治疗效果取决于基础血浆和心肌水平。辅酶Q10治疗可被认为是慢性心力衰竭传统治疗中的一种有效辅助手段。
