Heart failure? What exactly is heart failure, medically speaking?

Dr. Svend Aage Mortensen

Cardiologist Dr. Svend Aage Mortensen was the lead researcher on the Q-Symbio study of the effect of Coenzyme Q10 on morbidity and mortality in chronic heart failure patients, a randomized, double-blind, placebo-controlled study.

Heart failure does not mean that the heart stops. No, it means that the heart muscle no longer pumps blood and oxygen out to the body as efficiently as it should. It means that the heart muscle has insufficient power.

Supplementation of chronic heart failure patients with a well-formulated CoQ10 preparation is a therapeutic approach with a major clinical impact on patients’ heart health and quality of life. Adjuvant CoQ10 therapy is associated with improved heart muscle bioenergetics and with substantial reductions in inflammatory and oxidative stress markers. Several randomized clinical trials have demonstrated these beneficial outcomes in heart failure patients [Martelli 2020].

Symptoms of Heart Failure

Do not hesitate to consult a cardiologist if you have the following symptoms:

  • Shortness of breath
  • Fatigue
  • Palpitations
  • Build-up of fluid and congestion in the lungs
  • Swelling in the feet, ankles, legs, or belly
  • Confusion

Prevention of Heart Failure

Every year, some 6.6 million people in the United States are diagnosed with heart failure.

  • Eat wisely
  • Exercise regularly
  • Stop smoking
  • Lose weight

As a further precaution, take 200-300 mg of Coenzyme Q10 daily, in divided doses, with meals [Martelli 2020].

Treatment of Heart Failure

There is no cure for heart failure. It is a disabling disease with a poor prognosis despite advances in drug therapies and medical device therapies. For this reason, adjuvant treatment with Coenzyme Q10 is most important. [Mortensen 2015].

Coenzyme Q10 is essential for energy generation and antioxidant protection in heart muscle cells [Mortensen 2015]. In the Q-Symbio clinical trial, chronic heart failure patients took 3 x 100 mg daily or matching placebos in additional to conventional heart failure therapy for two years. The CoQ10 adjuvant treatment clearly improved the functional status of the heart failure patients [Mortensen 2014].

Compared to the placebo group, the active treatment group had the following beneficial heart health outcomes [Mortensen 2014]:

  • a 43% reduction in major adverse cardiovascular events
  • a 43% reduction in cardiovascular death
  • a 42% reduction in death from all causes

Conclusion: Coenzyme Q10 as Adjunctive Treatment for Heart Failure Patients

  • Coenzyme Q10 supplementation improves physical and functional status.
  • Coenzyme Q10 supplementation reduces the risk of unplanned hospitalization and death.
  • The good heart health benefits have been achieved with the ubiquinone form of CoQ10 supplement.
  • Taking a well-formulated CoQ10 supplement with documented absorption and bioavailability is important – not all CoQ10 supplements are absorbed equally well – and without good absorption, there are no benefits to the supplementation.
  • In humans, the bioavailability of supplements with Coenzyme Q10 seems to depend much more on the formulation of the supplement – the choice of excipients and the heating/cooling process – than it does on the form of the supplement, i.e., whether ubiquinone or ubiquinol [Lopez-Lluch 2019].


López-Lluch G, Del Pozo-Cruz J, Sánchez-Cuesta A, Cortés-Rodríguez AB, Navas P. Bioavailability of coenzyme Q10 supplements depends on carrier lipids and solubilization. Nutrition. 2019 Jan;57:133-140.

Martelli A, Testai L, Colletti A, Cicero AFG. Coenzyme Q10: Clinical Applications in Cardiovascular Diseases. Antioxidants (Basel). 2020 Apr 22;9(4):341.

Mortensen SA, Rosenfeldt F, Kumar A, Dolliner P, Filipiak KJ, Pella D, Alehagen U, Steurer G, Littarru GP; Q-SYMBIO Study Investigators. The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial. JACC Heart Fail. 2014 Dec;2(6):641-9.

Mortensen SA. Coenzyme Q10: will this natural substance become a guideline-directed adjunctive therapy in heart failure? JACC Heart Fail. 2015 Mar;3(3):270-1.

Mortensen AL, Rosenfeldt F, Filipiak KJ. Effect of coenzyme Q10 in Europeans with chronic heart failure: A sub-group analysis of the Q-SYMBIO randomized double-blind trial. Cardiol J. 2019;26(2):147-156.

The information presented in this review article is not intended as medical advice and should not be used as such.