Background

Heart failure with preserved ejection fraction (HFpEF) is common in elderly people and is increasing in prevalence. No specific treatment for this condition exists. Coenzyme Q10 (CoQ10) is an essential cofactor for energy production, with reduced levels being noted in HF. Previous studies have suggested a possible role for CoQ10 in the treatment of HF. This study examined the effect of CoQ10 supplementation on diastolic function in HFpEF patients.

Methods

We conducted a prospective, randomized, double-blind, placebo-controlled trial including patients aged > 55 years presenting with New York Heart Association class II–IV heart failure symptoms and left ventricular ejection fraction > 50%, with impaired diastolic function. Echocardiography and levels of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) were performed at baseline and following 4 months of CoQ10 or placebo supplementation.

Results

A total of 39 patients were enrolled—19 in the CoQ10 group and 20 in the placebo group. Baseline clinical characteristics were similar between groups, while compliance was high and also similar between the CoQ10 and placebo groups. There was no significant effect of treatment on indices of diastolic function (difference in the lateral E/e' ratio: −0.86 ± 6.57 in the CoQ10 group, +0.18 ± 3.76 in the placebo group; p = 0.561) or on serum NT-proBNP levels (− 72 pg/mL vs. − 42 pg/mL; p = 0.195).

Conclusions

In this pilot trial in elderly patients with HFpEF, treatment with CoQ10 did not significantly affect echocardiographic indices of diastolic function and serum NT-proBNP levels.

Trial Registration

This trial was registered in the US National Institutes of Health Clinical Trials Registry (ClinicalTrials.gov identifier: NCT02779634).

中文翻译：

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辅酶 Q10 治疗保留射血分数的心力衰竭：一项前瞻性、随机、双盲、安慰剂对照试验

背景

射血分数保留的心力衰竭 (HFpEF) 在老年人中很常见，并且患病率正在增加。没有针对这种情况的特定治疗方法。辅酶 Q10 (CoQ10) 是产生能量的重要辅助因子，在 HF 中水平降低。以前的研究表明，辅酶 Q10 在 HF 治疗中可能发挥作用。本研究检查了补充 CoQ10 对 HFpEF 患者舒张功能的影响。

方法

我们进行了一项前瞻性、随机、双盲、安慰剂对照试验，纳入年龄 > 55 岁、出现纽约心脏协会 II-IV 级心力衰竭症状和左心室射血分数 > 50% 且舒张功能受损的患者。在基线和补充辅酶 Q10 或安慰剂 4 个月后进行超声心动图和血清 N 末端前 B 型利钠肽 (NT-proBNP) 水平。

结果

共招募了 39 名患者——辅酶 Q10 组 19 名，安慰剂组 20 名。两组之间的基线临床特征相似，而辅酶Q10和安慰剂组之间的依从性很高并且也相似。治疗对舒张功能指标（侧向E / e ' 比的差异：辅酶 Q10 组 -0.86 ± 6.57，安慰剂组 +0.18 ± 3.76；p  = 0.561）或血清 NT-没有显着影响proBNP 水平（- 72 pg/mL 与 - 42 pg/mL；p  = 0.195）。

结论

在这项针对 HFpEF 老年患者的初步试验中，辅酶 Q10 治疗并未显着影响超声心动图的舒张功能指数和血清 NT-proBNP 水平。

试用注册

该试验已在美国国立卫生研究院临床试验注册中心注册（ClinicalTrials.gov 标识符：NCT02779634）。