Professor Franklin Rosenfeldt, MD and Fellow of the Royal College of Surgeons (Edinburgh), is an adjunct professor and cardiac surgeon in the Department of Surgery, Monash University, a university based in Melbourne, Australia. Dr. Rosenfeldt is also the administrative supervisor of The Integrative Cardiac Wellness Program at The Alfred, a tertiary teaching hospital in Prahran, (a suburb of Melbourne), Victoria, Australia.
Q10 research at The Alfred
The Alfred’s services include heart and lung replacement and transplantation as well as many other specialized services. For 30 years, Dr. Rosenfeldt has been conducting cardiac surgery research at The Alfred. His special research interest has been the protection of the heart against damage during heart surgery. In this context, he has done much research on the role of 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 and fish oil in the management of heart disease.
Dr. Rosenfeldt’s research interests
Actually, Dr. Rosenfeldt’s concern for the welfare of heart patients extends beyond the use of 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 and fish oil supplements and includes the use of mind-body medicine, music, meditation, stress reduction, and physical exercise. In this article, I want to summarize some of 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 studies that Professor Rosenfeldt has been involved in.
Second author on the Q-Symbio studyQ-Symbio is the abbreviated name for the two-year multi-center, randomized, double-blind, placebo-controlled study of Coenzyme Q10 supplements as an adjunct treatment of chronic heart failure patients. The name reflects the focus of the study on the SYMptoms, BIomarker status (BNP), and long-term Outcomes (hospitalizations and mortality) of the supplementation. The data from the Q-Symbio study show that long-term supplementation with... More
Now, where to start? That is easy. Dr. Rosenfeldt was the second author, behind Dr. Svend Aage Mortensen, on the article reporting the results of the Q-Symbio studyQ-Symbio is the abbreviated name for the two-year multi-center, randomized, double-blind, placebo-controlled study of Coenzyme Q10 supplements as an adjunct treatment of chronic heart failure patients. The name reflects the focus of the study on the SYMptoms, BIomarker status (BNP), and long-term Outcomes (hospitalizations and mortality) of the supplementation. The data from the Q-Symbio study show that long-term supplementation with... More in the December, 2014, issue of the Journal of the American College of Cardiology 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 professional journal.
The Q-Symbio study was an international multi-center study, and Dr. Rosenfeldt led the Australian part of the study. Q-Symbio showed that Q10 supplementation results in significantly fewer adverse cardiovascular events, including fewer hospitalizations and fewer deaths.
Supplementation with Q10 and other micro-nutrients
In 2010, Dr. Rosenfeldt and a team of colleagues reported on the beneficial effects of pre-surgery supplementation with a combination of micro-nutrients:
- 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
- alpha-lipoic acid
- magnesium orotate
- seleniumSelenium (symbol Se, atomic number 34) is a trace element that is an essential nutrient and an essential component of some of the most important antioxidants in the body, in particular the selenoproteins glutathione peroxidase, thioredoxin reductase, and selenoprotein P. Selenium is involved in the optimal functioning of the immune system. Professor Alehagen has pointed out that there exists a... More
- fish oil (containing omega-3 fatty acids)
The study enrolled 117 patients who were scheduled to undergo elective coronary artery bypass graft and/or heart valve surgery. The patients’ average age was 65 years; the ratio of male to female patients was 3:1.
Randomized, double-blindA double-blind study is a study in which neither the investigators nor the study participants know which participants are receiving the active treatment and which participants are receiving the control treatment until the study has been completed and the seal on the code has been broken. More, placebo-controlled study of Q10
The researchers randomly assigned the patients, in double-blinded manner, to a micro-nutrient treatment group or to a placebo control group. The purpose of the research was to use the micro-nutrient treatment for a period of up to two months before surgery and for at least one month after surgery to reduce the harmful effects of the oxidative stress caused during the surgery and to improve the elderly and high-risk patients’ recovery from the surgery.
Less damage to the heart = shorter hospital stays
The results of the study showed that the use of 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 and the other micro-nutrients prior to and following surgery did reduce the extent of damage to the heart muscle and did shorten the length of the hospital stay after surgery. The micro-nutrient pre-treatment of surgery patients was safe; there were no clinically significantThe outcome of a clinical trial is thought to have statistical significance, or to be statistically significant, if the outcome is likely not caused by chance at a given statistical significance level, typically at the 0.05 level. Statistically significant outcomes may or may not be clinically significant. More side effects (1).
Q10 supplementation before heart surgery safe
Dr. Rosenfeldt’s micro-nutrient treatment study with 117 patients built on the results of an earlier study, published in 2006, that enrolled 16 patients and that showed that micro-nutrient treatment including 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 prior to and following surgery has the following characteristics:
- is safe
- is affordable
- reduces the number and extent of complications after surgery
- improves post-operative recovery
As such, supplementation for an average of 36 days prior to surgery with daily doses of the following micro-nutrients benefited not the patients but also the entire health care system (2).
- 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 (300 mg)
- alpha-lipoic acid (300 mg)
- magnesium (1200 mg)
- fish oil (3000 mg)
No increased risk of bleeding with Q10 supplementation
In these above-mentioned studies, Dr. Rosenfeldt and his colleagues demonstrated that the use of 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 and fish oil supplements before surgery does not increase the risk of bleeding during or after surgery (1,2).
Enhanced energy production and antioxidantAntioxidants are substances that protect the cells and lipoproteins against the harmful effects of free radicals. They are substances that prevent the oxidation of other molecules and compounds. There are two broad categories of antioxidants: enzymatic and non-enzymatic. Non-enzymatic antioxidants are substances like Coenzyme Q10, vitamin C, vitamin E, glutathione, and various carotenoids. Prominent enzymatic antioxidants include catalase, glutathione peroxidase,... More protection with Q10
The studies done by Dr. Rosenfeldt and his colleagues show that the micro-nutrients, 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 in particular, improve the outcome of heart surgery in the following ways:
- by enhancing the cellular energy production in the heart
- by protecting the heart against the damage caused by oxidative stress (defined as the harmful effects of chains of free radicalsFree radicals are unstable and highly reactive molecules that are produced in the body during normal oxygen metabolism. Free radicals derived from oxygen are known as reactive oxygen species. Free radicals play both helpful and harmful roles in the body. Free radicals steal electrons from other substances in order to become stable. In so doing, the free radicals oxidize those... More in the cells and tissues)
- by protecting the heart against the stress and damage caused by depriving the heart muscles of oxygen (known as hypoxia) and by then re-introducing oxygen to the oxygen-starved heart muscle cells (known as reperfusionsee ischemia-reperfusion. injury)
Q10 supplementation saves money for the health care system
Dr. Rosenfeldt’s studies show that the cost of the Q10 and micro-nutrient supplements is a small fraction of the amount of savings that can be realized by hospital and health insurance systems when the heart surgery patients suffer fewer complications and require fewer days of hospitalization. The savings, per individual patient, to the health care system were, on average, seven times the cost of the supplements used by the patient.
Increased Q10 levels in serum and tissue and 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 2005, Dr. Rosenfeldt and his colleagues reported on research that is astonishing for a lay person like me. They excised and examined small bits of tissue from the right atrium of the patients’ hearts. They found increased levels of Q10 in the serum, in the heart tissue, and in isolated 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 of the patients who had received the Q10 supplement as compared to the patients who had received the placebo supplement.
Improved tissue recovery with Q10 supplementation
Then, in the organ bath, the Aussie researchers subjected the excised heart tissue to 30 minutes of a lack of oxygen. After that, they tested the recovery of force in the heart tissue, and they found that the Q10-supplemented heart tissue recovered much better than the unsupplemented heart tissue (3).
Lower levels of oxidative damage marker with Q10 supplementation
In another aspect of the research, the researchers tested for markers of oxidative damage, and they found that the content of mitochondrial malondialdehyde was significantly lower in Q10-supplemented tissue than in placebo-supplemented tissue (3). Malondialdehyde is a known marker for oxidative stress.
No adverse effect of Q10 on hemodynamics
Finally, Dr. Rosenfeldt and the team of researchers showed that there were no differences between the pre-treatment flow and the post-treatment flow of blood in patients supplemented with Q10. Nor were there any discernible differences before the Q10 treatment and after the Q10 treatment in the release of a protein marker (troponin I) for heart damage (3).
More later about Dr. Rosenfeldt and Q10 supplementation
There are still more research reports from Dr. Rosenfeldt and his colleagues in Australia to be summarized. For example, they have published interesting reviews of the effect of Q10 supplementation on cardiovascular disease, on hypertensionHypertension is abnormally high blood pressure, usually defined as adult systolic blood pressure above 140 mm Hg or adult diastolic blood pressure above 90 mm Hg. Systolic blood pressure is blood pressure measured during the contracting (pumping) of the left ventricle of the heart. Diastolic blood pressure is blood pressure measured during the relaxation of the left ventricle. A meta-analysis... More, and on physical exercise. They have published on the need for Q10 supplementation whenever heart disease patients are taking statin medications (4). I will present their findings on these topics in future articles.
Sources
- Leong, J., van der Merwe, J., Pepe, S., Bailey, M., Perkins, A., Lymbury, R., & … Rosenfeldt, F. (2010). Perioperative metabolic therapy improves redox status and outcomes in cardiac surgery patients: a randomised trial. Heart, Lung & Circulation, 19(10), 584-591. doi:10.1016/j.hlc.2010.06.659
- Hadj, A., Esmore, D., Rowland, M., Pepe, S., Schneider, L., Lewin, J., & Rosenfeldt, F. (2006). Pre-operative preparation for cardiac surgery utilising a combination of metabolic, physical and mental therapy. Heart, Lung & Circulation, 15(3), 172-181.
- Rosenfeldt, F., Marasco, S., Lyon, W., Wowk, M., Sheeran, F., Bailey, M., & … Pepe, S. (2005). 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 before cardiac surgery improves mitochondrial function and in vitro contractility of myocardial tissue. The Journal of Thoracic and Cardiovascular Surgery, 129(1), 25-32.
- Ashton, E., Windebank, E., Skiba, M., Reid, C., Schneider, H., Rosenfeldt, F., & … Krum, H. (2011). Why did high-dose rosuvastatin not improve cardiac remodeling in 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? Mechanistic insights from the UNIVERSE study. International Journal of Cardiology, 146(3), 404-407.