What is it that we need to improve the generally poor prognosis given to chronic heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More patients? Heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More is, at its most basic, the inability of the heart to pump out sufficient blood so that the body gets the oxygen and the nutrients that it needs. Heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More is the condition in which fluid builds up in the lungs and in the lower extremities because of the inadequate pumping action of the heart. Heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More is feeling tired and out of breath at the slightest exertion.
What are the levels of heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More?
The New York Heart AssociationSee NYHA More NYHAThe New York Heart Association Functional Classification distinguishes four categories of heart failure according to how much the patients are limited in their physical activity. Category I: No limitation of physical activity. No undue fatigue, palpitation, or shortness of breath. Category II: Slight limitation of physical activity. Comfortable at rest. Fatigue, palpitation, or shortness of breath at ordinary physical activity.... More) has devised a system for the functional classification of heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More:
- Class I: able to do ordinary physical activity; higher levels of exertion cause fatigue and shortness of breath
- Class II: at ease when at rest but fatigued and short of breath at ordinary levels of physical activity
- Class III: low levels of activity cause fatigue, heart palpitation, and shortness of breath
- Class IV: tired and short of breath even at rest; light physical activity increases the discomfort
What are the expectancy rates for heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More?
It seems that, based on the results of epidemiological studies and clinical trials, researchers can use the NYHAThe New York Heart Association Functional Classification distinguishes four categories of heart failure according to how much the patients are limited in their physical activity. Category I: No limitation of physical activity. No undue fatigue, palpitation, or shortness of breath. Category II: Slight limitation of physical activity. Comfortable at rest. Fatigue, palpitation, or shortness of breath at ordinary physical activity.... More functional classifications to predict the one-year and three-year mortality expectancy in heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More patients [1].
Classes I/II:
82% life expectancy after one year
52% life expectancy after three years
Class III:
77% life expectancy after one year
34% life expectancy after three years
Class IV:
41% life expectancy after one year
0% life expectancy after three years
Remember: the above life expectancy percentages are group percentages, not individual percentages.
Class IV heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More patients are, essentially, in the end stage of the disease.
Encouraging results from studies with Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More
That is why it is so encouraging to see the results of the clinical trials like the Morisco study and the Q-Symbio study of the adjunctive treatment of heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More with Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More. The results show the patients’ improving their NYHAThe New York Heart Association Functional Classification distinguishes four categories of heart failure according to how much the patients are limited in their physical activity. Category I: No limitation of physical activity. No undue fatigue, palpitation, or shortness of breath. Category II: Slight limitation of physical activity. Comfortable at rest. Fatigue, palpitation, or shortness of breath at ordinary physical activity.... More functional class diagnosis.
How can we improve NYHAThe New York Heart Association Functional Classification distinguishes four categories of heart failure according to how much the patients are limited in their physical activity. Category I: No limitation of physical activity. No undue fatigue, palpitation, or shortness of breath. Category II: Slight limitation of physical activity. Comfortable at rest. Fatigue, palpitation, or shortness of breath at ordinary physical activity.... More functional class?
This brings us back to the original question: what can we do to improve the prognosis of heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More patients?
Don’t we need to do something to improve the pumping action of the heart?
Don’t we need to do something to increase the force of the contractions of the heart?
- The force of the contractions of the right ventricle, the chamber that pumps the blood into the pulmonary artery and to the lungs where the blood takes on oxygen?
- The force of the left ventricular chamber, the chamber that pumps the blood out to the body?
Inotrope drugs
The drugs that increase the force of the contractions of a muscle such as the heart muscle are called inotropes. The only guidelines-approved inotrope for use in heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More patients is the digoxin drug, a purified derivative from the foxglove plant (known as Digitalis lanata) [3]. Digoxin has the following pharmaceutical brand names:
- Cardoxin
- Digitek
- Lanoxin
- Lanoxicaps
Digoxin not a first choice drug
The thing about digoxin is that, given its limited margin of safety, it is probably not the first choice of the cardiologist for the treatment of heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More. The cardiologist is more likely to try other medications first:
- Angiotensin Converting Enzyme (ACE) Inhibitors, which should help lower blood pressure
- Aldosterone antagonists, which should help remove excess fluid from the body
- Beta blockers, which should reduce heart rate and lower blood pressure
- Diuretics, which should reduce the build-up of fluid in the lungs and in the feet and ankles
What about Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More as an indirect positive inotrope?
Coenzyme Q10 is involved as an electron and proton carrier in the cellular production of ATPATP (adenosine triphosphate) molecules are the high-energy molecules with easily broken phosphate bonds that release energy to the energy-requiring processes in the cells. Coenzyme Q10 is essential to the process of ATP production. More. Randomized controlled clinical trials have shown that adjuvant treatment of heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More patients with Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More leads to improved heart muscle performance and to improvements in the symptoms and quality of life and survival of the patients.
What’s not to like about Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More for heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More patients?
Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More has many things going for it as an additive treatment for heart failure [2]:
- It is safe and well-tolerated
- It does not interfere with the effects of Coumadin (warfarin)
- It does not interfere with the glycemic control of type-1 or type-2 diabetics
- It does not interfere with anti-hypertensive medications
- It can reduce hospitalizations and cardiovascular deaths
- It helps to replace the Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More that statin medications stop the body from producing
- It is affordable
Note, please: Anyone taking anti-coagulant medications or anti-hypertensive medications and anyone who is a diabetic should check with his or her physician before starting to take Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More. There should be no problem, but it is best to check first.
Note, too: It is very important to choose a Coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More preparation with a documented good absorption or, better yet, with a documented beneficial health effect.
Sources:
- Heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More expectancy. (2016). Nobel Heart Centre. Retrieved from http://www.singaporecardiologists.com/?p=373.
- Mortensen, S. A., & Mortensen, A. L. (2014). The mitochondriaThe mitochondria are the bean-shaped organelles in the cells. They are the key organelles with responsibility for the production of ATP energy molecules. More in heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More: a target for coenzyme Q10Coenzyme Q10 molecules are fat-soluble molecules that are both synthesized in the body and ingested in the diet and in supplements. Coenzyme Q10 is synthesized in the body in the same biological pathway as cholesterol. Bio-synthesis of Coenzyme Q10 begins to decline once humans reach their adult years. The reduced production of Coenzyme Q10 cannot be compensated in any practical... More therapy?. Clinical Pharmacology And Therapeutics, 96(6), 645-647.
- Yancy, C. W., Jessup, M., Bozkurt, B., Butler, J., Casey, D. J., Drazner, M. H., & … Wilkoff, B. L. (2013). 2013 ACCF/AHA guideline for the management of heart failureThe Mayo Clinic defines heart failure, also known as congestive heart failure and/or chronic heart failure, as the failure of the heart muscle to pump blood to the body adequately. In other words, heart failure is not a heart attack, and it is not death from heart disease, which its name might seem to imply. Heart failure is a condition... More: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal of The American College Of Cardiology, 62(16), e147-e239.