Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA; Houston Methodist Hospital, Houston, Texas, USA.
Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA; Houston Methodist Hospital, Houston, Texas, USA.
J Am Coll Cardiol. 2021 Feb 9;77(5):609-619. doi: 10.1016/j.jacc.2020.12.009.
Coenzyme Q (CoQ) is a naturally occurring compound that is found in animals and all humans. It has a fundamental role in cellular energy production. Although it is produced in the body, tissue deficiency can occur due to medications such as statins, which inhibit the mevalonate pathway. The clinical syndromes of statin-associated muscle symptoms (SAMS) and some of the features observed in patients with heart failure (HF) may be related to blood and tissue deficiency of CoQ. Numerous clinical trials of CoQ in SAMS have yielded conflicting results. Yet, the weight of evidence as reflected in meta-analyses supports the use of exogenous CoQ in SAMS. In patients with HF, large-scale randomized clinical trials are lacking, although one relatively contemporary trial, Q-SYMBIO, suggests an adjunctive role for CoQ. The possibility that statin-related CoQ deficiency may play a role in patients with diastolic HF is an intriguing hypothesis that warrants further exploration.
辅酶 Q（CoQ）是一种天然存在于动物和所有人类体内的化合物。它在细胞能量产生中起着基本作用。尽管它在体内产生，但由于抑制甲羟戊酸途径的药物（如他汀类药物）的作用，可能会发生组织缺乏。他汀类药物相关肌肉症状（SAMS）的临床综合征和心力衰竭（HF）患者观察到的一些特征可能与 CoQ 的血液和组织缺乏有关。大量 CoQ 治疗 SAMS 的临床试验得出了相互矛盾的结果。然而，荟萃分析所反映的大量证据支持 CoQ 在 SAMS 中的应用。在 HF 患者中，缺乏大规模的随机临床试验，尽管一项相对较新的试验 Q-SYMBIO 表明 CoQ 具有辅助作用。他汀类药物相关 CoQ 缺乏可能在舒张性 HF 患者中起作用的可能性是一个有趣的假设，值得进一步探索。
