Huang Ching-Hui, Kuo Chen-Ling, Huang Ching-Shan, Tseng Wan-Min, Lian Ie Bin, Chang Chia-Chu, Liu Chin-San
Division of Cardiology, Department of Internal Medicine, Changhua Christian Hospital Institute of Statistics and Information Science, National Changhua University of Education Vascular and Genomic Research Center Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua School of Medicine, Chung Shan Medical University, Taichung Department of Neurology, Changhua Christian Hospital, Changhua Graduate Institute of Integrative Medicine, China Medical University, Taichung, Taiwan.
Medicine (Baltimore). 2016 Aug;95(31):e4501. doi: 10.1097/MD.0000000000004501.
Exogenous administration of coenzyme Q10 (CoQ10) has been shown in experimental models to have a protective effect against ischemia-reperfusion injury. However, it is unclear whether follow-up plasma CoQ10 concentration is prognostic of left ventricular (LV) performance after primary balloon angioplasty in patients with acute ST segment elevation myocardial infarction (STEMI).We prospectively recruited 55 patients with STEMI who were treated with primary coronary balloon angioplasty. Plasma CoQ10 concentrations were measured before primary angioplasty (baseline) and 3 days, 7 days, and 1 month after STEMI using high-performance liquid chromatography. Echocardiography was performed at baseline and at 6-month follow-up. The control group comprised 54 healthy age- and sex-matched volunteers.Serial circulating CoQ10 concentrations significantly decreased with time in the STEMI group. The LV ejection fraction at 6-month follow-up positively correlated with the 1-month plasma CoQ10 tertile. Higher plasma CoQ10 concentrations at 1 month were associated with favorable LV remodeling and systolic function 6 months after STEMI. Multiple linear regression analysis showed that changes in CoQ10 concentrations at 1-month follow-up were predictive of LV systolic function 6 months after STEMI. Changes in CoQ10 concentrations correlated negatively with baseline oxidized low-density lipoprotein and fibrinogen concentrations and correlated positively with leukocyte mitochondrial copy number at baseline.Patients with STEMI who had higher plasma CoQ10 concentrations 1 month after primary angioplasty had better LV performance at 6-month follow-up. In addition, higher plasma CoQ10 concentration was associated with lower grade inflammatory and oxidative stress status. Therefore, plasma CoQ10 concentration may serve as a novel prognostic biomarker of LV systolic function after revascularization therapy for acute myocardial infarction.
在实验模型中已表明，外源性给予辅酶Q10（CoQ10）对缺血再灌注损伤具有保护作用。然而，急性ST段抬高型心肌梗死（STEMI）患者接受初次球囊血管成形术后，后续血浆CoQ10浓度是否可预测左心室（LV）功能尚不清楚。我们前瞻性招募了55例接受初次冠状动脉球囊血管成形术治疗的STEMI患者。采用高效液相色谱法在初次血管成形术前（基线）以及STEMI后3天、7天和1个月测量血浆CoQ10浓度。在基线和6个月随访时进行超声心动图检查。对照组包括54名年龄和性别匹配的健康志愿者。STEMI组中，循环CoQ10浓度随时间显著降低。6个月随访时的左心室射血分数与1个月时的血浆CoQ10三分位数呈正相关。STEMI后1个月时较高的血浆CoQ10浓度与6个月时良好的左心室重构和收缩功能相关。多元线性回归分析表明，1个月随访时CoQ10浓度的变化可预测STEMI后6个月的左心室收缩功能。CoQ10浓度的变化与基线氧化型低密度脂蛋白和纤维蛋白原浓度呈负相关，与基线时白细胞线粒体拷贝数呈正相关。初次血管成形术后1个月血浆CoQ10浓度较高的STEMI患者在6个月随访时左心室功能更好。此外，较高的血浆CoQ10浓度与较低级别的炎症和氧化应激状态相关。因此，血浆CoQ10浓度可能作为急性心肌梗死血管重建治疗后左心室收缩功能的一种新型预后生物标志物。
