Morisco C, Nappi A, Argenziano L, Sarno D, Fonatana D, Imbriaco M, Nicolai E, Romano M, Rosiello G, Cuocolo A
1 Clinica Medica, Università degli Studi Federico II, Napoli, Italy.
Mol Aspects Med. 1994;15 Suppl:s155-63. doi: 10.1016/0098-2997(94)90025-6.
In patients with chronic heart failure (CHF), the addition of coenzyme Q10 to conventional therapy reduces the hospitalization rate for worsening of heart failure and the incidence of serious cardiovascular complications. The present study was planned to assess the hemodynamic mechanisms underlying this phenomenon. Cardiac hemodynamics was evaluated continuously using an ambulatory radionuclide detector (VEST) which allows a noninvasive monitoring of left ventricular function. Six patients wit CHF (mean ejection fraction (EF): 29%) clinically documented were studied. This study was organized as a randomized double-blind, placebo controlled, cross-over trial. The enrolled patients, after a washout period, underwent the first hemodynamic evaluation with VEST. Subsequently they were randomized to receive placebo or coenzyme Q10 for 4 weeks. At the end of this period they underwent the second VEST study. The third VEST study was performed after a further 4-week period with inverted treatment. Cardiac hemodynamics were evaluated during bicycle exercise. The EF in control conditions (CC) changed from 27 +/- 11%, at rest, to 24 +/- 8%, at peak exercise. During coenzyme Q10 treatment EF showed a significant increase both at rest (33 +/- 13%, P < 0.05 vs CC) and at peak exercise (30 +/- 12%, P < 0.05 vs CC). The same trends were recorded for the stroke volume and the cardiac output. Our results demonstrate that coenzyme Q10 improves cardiac hemodynamic response to exercise in patients with CHF and suggest that noninvasive monitoring of left ventricular function allows a more reliable assessment of therapy efficacy.
在慢性心力衰竭（CHF）患者中，在传统治疗基础上加用辅酶Q10可降低因心力衰竭恶化导致的住院率以及严重心血管并发症的发生率。本研究旨在评估这一现象背后的血流动力学机制。使用动态放射性核素探测器（VEST）连续评估心脏血流动力学，该探测器可对左心室功能进行无创监测。对6例临床确诊的CHF患者（平均射血分数（EF）：29%）进行了研究。本研究设计为随机双盲、安慰剂对照、交叉试验。入选患者在洗脱期后，接受VEST进行首次血流动力学评估。随后，他们被随机分为接受安慰剂或辅酶Q10治疗4周。在此期间结束时，他们接受第二次VEST研究。在进一步4周的反向治疗期后进行第三次VEST研究。在自行车运动期间评估心脏血流动力学。对照条件（CC）下的EF在静息时从27±11%变化至运动峰值时的24±8%。在辅酶Q10治疗期间，EF在静息时（33±13%，与CC相比P<0.05）和运动峰值时（30±12%，与CC相比P<0.05）均显著增加。每搏输出量和心输出量也记录到相同趋势。我们的结果表明，辅酶Q10可改善CHF患者运动时的心脏血流动力学反应，并表明对左心室功能的无创监测可更可靠地评估治疗效果。
