Mortensen S A, Vadhanavikit S, Baandrup U, Folkers K
Drugs Exp Clin Res. 1985;11(8):581-93.
Coenzyme Q10 (CoQ10) treatment, orally administered as 100 mg daily dose, was initiated in a series of patients with advanced heart failure in an open, controlled design. They were all showing an insufficient response to classical therapy with diuretics and digitalis. Twelve patients with various causes of heart failure, classified clinically by echocardiography (ECHO), (12/12), and heart catheterization with endomyocardial biopsy, (10/12), were followed prospectively for a mean period of seven months. Serial assessments: Clinical examination (with questionnaire), ECG, chest X-ray, ECHO, systolic time intervals (STI) and blood levels of CoQ10 were performed. With a mean latency period of 30 days, eight out of 12 patients (67%) showed definite clinical improvement. Subjectively, the patients felt less tired, their general activity tolerance increased and dyspnoea at rest disappeared. There were obvious signs of decreased right-sided stasis (hepatic congestion). The heart rate fell significantly, and the heart volume (chest X-ray) decreased in the eight responders (although n.s.). A significant reduction in the left atrial size (ECHO) was registered, suggesting a reduced preload of the left ventricle, Furthermore, a significant decline in the PEP/LVET ratio (STI) was indicative of an improved myocardial performance. Preliminary CoQ10 withdrawal results showed severe clinical relapse with subsequent improvement on CoQ10 reinstatement, supporting the interpretation that treatment of these patients corrected a myocardial deficiency of CoQ10 and increased contractility. Hence CoQ10 appears to be an effective therapeutic agent in advanced cases of heart failure. This is an attractive circumvention of the traditional principles of therapy: supporting the myocardium directly by ameliorating a supposed underlying mitochondrial dysfunction (exhausted bioenergetics).
辅酶Q10（CoQ10）采用每日100毫克的口服剂量，以开放、对照设计对一系列晚期心力衰竭患者进行治疗。这些患者对利尿剂和洋地黄的传统治疗反应不佳。对12例因各种原因导致心力衰竭的患者进行了前瞻性随访，平均为期7个月，这些患者通过超声心动图（ECHO）进行临床分类（12/12），并通过心内膜心肌活检进行心脏导管检查（10/12）。进行了系列评估：临床检查（包括问卷调查）、心电图、胸部X光、ECHO、收缩期时间间期（STI）以及CoQ10的血药浓度。平均潜伏期为30天，12例患者中有8例（67%）表现出明确的临床改善。主观上，患者感觉疲劳减轻，总体活动耐量增加，静息时呼吸困难消失。有明显迹象表明右侧淤血（肝淤血）减轻。8例有反应的患者心率显著下降，心脏体积（胸部X光）减小（尽管无统计学意义）。左心房大小（ECHO）显著减小，提示左心室前负荷降低。此外，PEP/LVET比值（STI）显著下降表明心肌功能改善。CoQ10初步撤药结果显示临床严重复发，再次使用CoQ10后病情改善，这支持了以下解释：对这些患者的治疗纠正了CoQ10的心肌缺乏并增强了收缩力。因此，CoQ10似乎是晚期心力衰竭病例的一种有效治疗药物。这是对传统治疗原则的一种有吸引力的规避：通过改善假定的潜在线粒体功能障碍（生物能量耗竭）直接支持心肌。
