Sharma Abhinav, Fonarow Gregg C, Butler Javed, Ezekowitz Justin A, Felker G Michael
From the Division of Cardiology, Duke University School of Medicine, Duke Heart Center, Durham, NC (A.S., G.M.F.); Division of Cardiology, Canadian VIGOUR Centre, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton (A.S., J.A.E.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan UCLA Medical Center (G.C.F.); and Department of Medicine, Division of Cardiology, Stony Brook University, NY (J.B.).
Circ Heart Fail. 2016 Apr;9(4):e002639. doi: 10.1161/CIRCHEARTFAILURE.115.002639.
Heart failure (HF) with either preserved or reduced ejection fraction is associated with increased morbidity and mortality. Evidence-based therapies are often limited by tolerability, hypotension, electrolyte disturbances, and renal dysfunction. Coenzyme Q10 (CoQ10) may represent a safe therapeutic option for patients with HF. CoQ10 is a highly lipophilic molecule with a chemical structure similar to vitamin K. Although being a common component of cellular membranes, CoQ10's most prominent role is to facilitate the production of adenosine triphosphate in the mitochondria by participating in redox reactions within the electron transport chain. Numerous trials during the past 30 years examining CoQ10 in patients with HF have been limited by small numbers and lack of contemporary HF therapies. The recent publication of the Q-SYMBIO randomized controlled trial demonstrated a reduction in major adverse cardiovascular events with CoQ10 supplementation in a contemporary HF population. Although having limitations, this study has renewed interest in evaluating CoQ10 supplementation in patients with HF. Current literature suggests that CoQ10 is relatively safe with few drug interactions and side effects. Furthermore, it is already widely available as an over-the-counter supplement. These findings warrant future adequately powered randomized controlled trials of CoQ10 supplementation in patients with HF. This state-of-the-art review summarizes the literature about the mechanisms, clinical data, and safety profile of CoQ10 supplementation in patients with HF.
射血分数保留或降低的心力衰竭（HF）与发病率和死亡率增加相关。循证治疗往往受到耐受性、低血压、电解质紊乱和肾功能不全的限制。辅酶Q10（CoQ10）可能是HF患者的一种安全治疗选择。CoQ10是一种高度亲脂性分子，其化学结构与维生素K相似。尽管CoQ10是细胞膜的常见成分，但其最突出的作用是通过参与电子传递链中的氧化还原反应来促进线粒体中三磷酸腺苷的产生。在过去30年中，众多针对HF患者使用CoQ10的试验因样本量小且缺乏当代HF治疗方法而受到限制。Q-SYMBIO随机对照试验的最新发表表明，在当代HF人群中补充CoQ10可减少主要不良心血管事件。尽管该研究存在局限性，但它重新激发了人们对评估HF患者补充CoQ10的兴趣。当前文献表明，CoQ10相对安全，药物相互作用和副作用较少。此外，它作为非处方补充剂已广泛可得。这些发现值得未来对HF患者补充CoQ10进行有足够样本量的随机对照试验。这篇综述总结了关于HF患者补充CoQ10的机制、临床数据和安全性的文献。
