European Heart Journal Advance Access originally published online on July 19, 2007
European Heart Journal 2007 28(18):2249-2255; doi:10.1093/eurheartj/ehm267
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Effect of coenzyme Q10 administration on endothelial function and extracellular superoxide dismutase in patients with ischaemic heart disease: a double-blind, randomized controlled study
1 Institute of Biochemistry, Polytechnic University of the Marche, Via Ranieri, 60100 Ancona, Italy
2 Lancisi Heart Institute, Azienda Ospedali Riuniti, Ancona, Italy
3 Salesi Paediatric Hospital, Polytechnic University of the Marche, Ancona, Italy
4 Department of Agronomical Sciences and Agronomical Vegetal Genetics, University of Sassari, Sassari, Italy
Received 30 June 2006; revised 30 May 2007; accepted 7 June 2007; online publish-ahead-of-print 19 July 2007.
* Corresponding author. Tel: +39 071 2204394; fax +39 071 2204398. E-mail address: luca.tiano{at}unicam.it
Aims: This randomized controlled study was designed to determine whether oral coenzyme Q10 (CoQ10) supplementation (100 mg tid) was able to improve extracellular superoxide dismutase (ecSOD) activity and endothelium-dependent (ED) vasodilation in patients with coronary artery disease (CAD). ecSOD, a major antioxidant enzyme system of the vessel wall, is reduced in patients with CAD. Moreover, there is a strong correlation between endothelium-bound ecSOD and the ED dilation of conduit arteries. CoQ10 has been recently shown to improve the ED relaxation in diabetic patients.
Methods and results: Thirty-eight CAD patients (33 M/5 F, mean age 55 ± 4 years, ejection fraction 57.5 ± 8%) were randomized into two groups. One group (n = 19) received CoQ10 orally at doses of 300 mg/day for 1 month, whereas the other group received a placebo. On entry and after 1 month, all patients underwent brachial artery ED assessment, cardiopulmonary exercise test, and the measurement of endothelium-bound ecSOD activity. A total of 33 patients completed the study. ecSOD, ED relaxation, as well as peak VO2 and O2 pulse increases in the CoQ10-treated group were statistically greater vs. the variations in the placebo group. In particular, improvements elicited by CoQ10 supplementation were remarkable in subjects presenting low initial endothelium-bound ecSOD and thus more prone to oxidative stress.
Conclusion: Improvements in the ED relaxation and endothelium-bound ecSOD activity might be related to CoQ10 capability of enhancing endothelial functionality by counteracting nitric oxide oxidation. The enhancement of peak VO2 and of O2 pulse is likely due to the bioenergetic effect of CoQ10; on the other end, the improved VO2 could also depend on the observed enhanced peripheral endothelial function.
Key Words: Coenzyme Q10 • Extracellular superoxide dismutase • Endothelium-dependent vasorelaxation