Heart Failure
Noninvasive evaluation of cardiac hemodynamics during exercise in patients
with chronic heart failure: effects of short-term coenzyme Q10 treatment.
Morisco C; Nappi A; Argenziano L; Sarno D; Fonatana D; Imbriaco
M; Nicolai E; Romano M; Rosiello G; Cuocolo A
Molecular Aspects of Medicine 1994;15 Suppl:s155-63
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.
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