Abstract
The study aims to examine the effects of coenzyme Q10, (a bioenergetic antioxidant), on the indexes of left ventricular remodeling, oxidative damage, and angiotensin-converting enzyme (ACE) level after acute myocardial infarction (AMI) with left ventricular dysfunction. In a double blind, randomized, placebo-controlled, parallel group study (a retrospective analysis of an earlier trial) in 55 patients with left ventricular ejection fraction <50% after AMI, the effects of coenzyme Q10 (120 mg/day) or placebo were studied for 24 weeks. Two-dimensional echocardiography was performed at discharge, (approximately 5–10 days after admission) and at 6 months after AMI. The results revealed that wall thickness opposite the site of infarction decreased from (mean ± standard deviation (SD)) 12.2 ± 2.0 mm to 10.0 ± 1.8 mm with coenzyme Q10 compared with 12.8 ± 2.2 mm to 13.3 ± 2.3 mm with placebo (p < 0.01). Left ventricular mass changed from 236 ± 72 g to 213 ± 61 g with coenzyme Q10 compared with 230 ± 77 g to 255 ± 86 g with placebo (p < 0.01). Treatment with coenzyme Q10 also prevented alteration of sphericity index which is a ratio of the long and short axis of the left ventricle (which changed from 1.61 ± 0.28 to 1.63 ± 0.30 with coenzyme Q10 compared with 1.61 ± 0.32 to 1.41 ± 0.31 with placebo (p < 0.05)). Coenzyme Q10 also prevented alteration of the wall thickening abnormality at the infarct site, which changed from 9.4 ± 3.0 cm2 to 9.1 ± 2.8 cm2 compared with 10.1 ± 3.1 to 13.7 ± 4.2 cm2 with placebo (p < 0.05). End diastolic and systolic volumes also showed significant reduction with coenzyme Q10 compared to placebo. The serum level of ACE showed significant decline in the coenzyme Q10 group compared to the control group. Treatment with coenzyme Q10 early after AMI causes attenuation of left ventricular remodeling and decreases the serum ACE level in patients with left ventricular dysfunction.
Highlights
A majority of the complications of acute myocardial infarction (AMI) are due to the presence of left ventricular dysfunction which appear to be on account of reperfusion-induced free radical damage, lipid peroxidation and decreased energy production as well as due to antioxidant vitamin and coenzyme Q10 deficiency [1,2,3,4]
We have examined the possible role of coenzyme Q10 on indexes of remodeling after AMI in those with impaired left ventricular function
Since these parameters were not obtained at the time of randomization, it is just possible that the placebo group was a higher risk group compared to treatment group resulting into more aggressive remodeling which is a limitation of our study
Summary
A majority of the complications of acute myocardial infarction (AMI) are due to the presence of left ventricular dysfunction which appear to be on account of reperfusion-induced free radical damage, lipid peroxidation and decreased energy production as well as due to antioxidant vitamin and coenzyme Q10 deficiency [1,2,3,4]. Antioxidants 2018, 7, 99 that manifest clinically as changes in size, mass, geometry and function of the heart after injury [1] These changes in ventricular remodeling in conjunction with antioxidant vitamin and coenzyme Q10 deficiency, may result in poor prognosis because of its association with ventricular dysfunction [1,2,3,4]. An expansion of infarct size, hypertrophy of non-infarcted myocardium, increased total left ventricular mass and alteration of left ventricular geometry are common in patients with left ventricular remodeling [5,6,7,8,9,10] These structural changes in the myocardium are associated with progressive left ventricular dysfunction and heart failure which is the major cause of morbidity and mortality in patients with AMI. Because no study has examined the role of coenzyme
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