PERSPECTIVES ON THERAPY OF CARDIOVASCULAR-DISEASES WITH COENZYME-Q(10) (UBIQUINONE)

A defective myocardial energy supply - due to lack of substrates and/o r essential cofactors and a poor utilization efficiency of oxygen may be a common final pathway in the progression of myocardial diseases of various etiologies. The vitaminlike essential substance coenzyme Q10, or ubiquinone, is a natural antioxidant and has a key role in oxidati ve phosphorylation. A biochemical rationale for using coenzyme Q10 as a therapy in heart disease was established years ago by Folkers and as sociates; however, this has been further strengthened by investigation s of viable myocardial tissue from the author's series of 45 patients with various cardiomyopathies. Myocardial tissue levels of coenzyme Q1 0 determined by high-performance lipid chromatography were found to be significantly lower in patients with more advanced heart failure comp ared with those in the milder stages of heart failure. Furthermore, th e myocardial tissue coenzyme Q10 deficiency might be restored signific antly by oral supplementation in selected cases. In the author's open clinical protocol study with coenzyme Q10 therapy (100 mg daily) nearl y two-thirds of patients revealed clinical improvement, most pronounce d in those with dilated cardiomyopathy. Double-blind placebo-controlle d trials have definitely confirmed that coenzyme Q10 has a place as ad junctive treatment in heart failure with beneficial effects on the cli nical outcome, the patients' physical activity, and their quality of l ife. The positive results have been above and beyond the clinical stat us obtained from treatment with traditional principles - including ang iotensin-converting enzyme inhibitors.