Heart failure is what happens when the heart is no longer able to pump out blood as strongly as it should. It occurs when the heart is too weak or too stiff to fill up with blood and pump out blood efficiently. It is characterized by reduced functional capacity and reduced quality of life:
- Reduced ability to exercise and do work
- Shortness of breath
- Swelling in the lower extremities
- Weakness and fatigue from exertion
Heart failure is one of the most costly medical conditions in terms of complications and hospitalizations. The costs of medical care for heart failure patients is expected to rise from $30 billion per year in 2018 to nearly $70 million by 2030 [Bhatt & Butler 2018].
Half of the patients diagnosed with heart failure die within five years of the diagnosis. Heart failure is a frequent cause of hospitalization and loss of physical function [Jafari 2018].
Q-Symbio Study of Coenzyme Q10 and Heart Failure
The Q-Symbio Study of the adjunctive treatment with 300 milligrams of Coenzyme Q10 daily for two years together with conventional heart failure medicine improved patients’ symptoms and survival significantly compared to placebo together with conventional heart failure medicine [Mortensen 2014].
Furthermore, the clinical benefits of Coenzyme Q10 supplementation in the prevention and treatment of heart failure have been documented in several Randomized controlled trials are studies in which patients or healthy volunteers are assigned at random (purely by chance) to receive one or more clinical interventions. One or more of the interventions is the active treatment being tested. Another of the interventions is the control against which the active treatment is being tested. The control is, typically, the standard practice or... Read more about this term enrolling a total of 4668 cardiovascular disease patients [Jafari 2018]:
- improved Ejection fraction, sometimes called left ventricular ejection fraction, measures the percentage of blood that the heart pumps out of the left ventricle with each heart contraction. According to the Mayo Clinic guidelines, an ejection fraction above 55% is regarded as normal. An ejection fraction under 50% is regarded as reduced. An ejection fraction below 40% is indicative of heart failure... Read more about this term
- improved See NYHA classification
- improved physical status
- improved survival
- better quality of life
How Does CoQ10 Adjunctive Treatment Help Heart Failure Patients?
Serum and plasma CoQ10 levels are generally lower in heart failure patients. Supplementation is needed to make up for the loss.
The Q-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... Read more about this term (n=420) and its forerunners, the Morisco Multi-Center Study (n=641) and the Baggio Multi-Center Study (n=2664), have shown that CoQ10 adjunctive treatment is safe, well-tolerated, and effective with moderate to severe heart failure patients. Moreover, it is an affordable add-on treatment that can save patients and hospitals much money in terms of fewer complications and fewer hospitalizations [Mortensen 2014; Morisco 1993; Baggio 1993].
The Heart Health Effects of Adjunctive CoQ10 Treatment
Jafari et al  enumerate three reasons for the effectiveness of CoQ10 treatment of heart failure patients:
- Coenzyme Q10 is an essential bio-nutrient for the cellular generation of See ATP (ATP (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.... Read more about this term) energy.
- Coenzyme Q10 reduces oxidative stress, high levels of which are a bio-marker of mortality in heart failure. In its reduced form, Coenzyme Q10 is a fat-soluble Antioxidants 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,... Read more about this term that prevents membrane Oxidation is the chemical process in which an atom or a molecule gives up (loses) one or more electrons to another substance. Burning is an example of a rapid process of oxidation. Rusting is an example of a slow process of oxidation. Oxidative stress and oxidative damage: structural damage to cell components such as proteins, lipids, and DNA that is... Read more about this term and Oxidation is the chemical reaction of a substance with oxygen. Peroxidation is the extreme form of oxidation that results from free radicals’ stealing electrons from lipids, either in the cell membranes or in the lipoproteins. The final product of lipid peroxidation is highly reactive malondialdehyde, a bio-marker for oxidative stress and damage.... Read more about this term.
- Coenzyme Q10 stabilizes calcium dependent ion channels in the heart muscle tissue.
Beyond these three biological functions, Coenzyme Q10 also provides the following benefits [Jafari 2018]:
- CoQ10 adjunctive treatment improves endothelial function, which is important for the contraction and relaxation of blood vessels and important for blood platelet adhesion and blood clotting.
- CoQ10 adjunctive treatment improves left ventricle contractility in patients with The 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... Read more about this term.
Coenzyme Q10 Supplementation and Reduced Levels of Chronic Inflammation
Zhai et al in a 2017 systematic review point to evidence from randomized controlled trials that show that CoQ10 supplementation reduces the levels of known bio-markers for chronic Inflammation is an immune system response to an injury to cells or tissues. It is the body’s attempt to defend against invaders such as bacteria andviruses and to mend the damage done by invaders. Typically, inflammation manifests itself in the form of fever and swelling, in the swarming of white blood cells and the release of cytokines to fight against... Read more about this term.
The evidence from the KiSel-10 Study of the Effect of combined CoQ10 and selenium supplementation on the heart function and cardiovascular mortality of health senior citizens shows that the combined treatment reduces the blood levels of bio-markers for chronic inflammation [Alehagen 2015; Alehagen 2019].
Summary: CoQ10 Adjunctive Treatment for Heart Failure
Admittedly, different types of The 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... Read more about this term may be associated with different responses to the CoQ10 adjunctive treatment, and individuals diagnosed with heart failure may respond differently to the CoQ10 adjunctive treatment.
Even so, the available evidence from randomized controlled trials suggests that CoQ10 adjuvant treatment can improve the symptoms and quality of life and survival of patients with heart failure [Ayers 2018].
The beneficial effects of CoQ10 supplementation on cellular energy generation, antioxidant defense of cells, maintenance of endothelial function, and chronic inflammation may explain the positive results seen in clinical trials of heart failure.
Important point: Not all Coenzyme Q10 supplements are equally well absorbed. The crystalline CoQ10 raw material is difficult to work with and difficult to dissolve at body temperature to single molecules. This is important because the human body cannot absorb CoQ10 crystals, only single CoQ10 molecules. Good quality manufacturing costs time and money. The best commercial CoQ10 supplements in terms of absorption and health benefits are not going to be the cheap formulations on the shelf.
Alehagen, U., Lindahl, T. L., Aaseth, J., Svensson, E., & Johansson, P. (2015). Levels of sP-selectin and hs-CRP Decrease with Dietary Intervention with Selenium (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... Read more about this term and Coenzyme Q10 Combined: A Secondary Analysis of a Randomized Clinical trials are research studies in which various treatments, interventions, or tests are investigated for their safety and efficacy when used to detect, prevent, or treat diseases and medical conditions in patients and healthy volunteers. The gold standard for clinical trials are randomized, double-blind, placebo-controlled studies.... Read more about this term. Plos One, 10(9), e0137680.
Alehagen, U., Alexander, J., Aaseth, J. & Larsson, A. (2019). Decrease in inflammatory biomarker concentration by intervention with selenium and Coenzyme Q10: a sub-analysis of osteopontin, osteoprotergerin, TNFr1, TNFr2, and TWEAK. Journal of Inflammation, 16,5,1-9.
Ayers J, Cook J, Koenig RA, Sisson EM, & Dixon DL. (2018). Recent developments in the role of coenzyme q10 for coronary heart disease: a systematic review. Curr Atheroscler Rep; 20(6):29.
Baggio, E., Gandini, R., Plancher, A. C., Passeri, M., & Carmosino, G. (1993). Italian multicenter study on the safety and efficacy of coenzyme Q10 as adjunctive therapy in heart failure (interim analysis). The CoQ10 Drug Surveillance Investigators. The Clinical Investigator, 71(8 Suppl), S145-S149.
Bhatt, KN & Butler J. (2018). Myocardial energetics and heart failure: a review of recent therapeutic trials. Current Heart Failure Reports; 15(3): 191-197.
Jafari M, Mousavi SM, Asgharzadeh A, Yazdani N. (2018). Coenzyme Q10 in the treatment of heart failure: A systematic review of systematic reviews. Indian Heart J; 70 Suppl 1: S111-S117.
Morisco, C., Trimarco, B., & Condorelli, M. (1993). Effect of coenzyme Q10 therapy in patients with congestive heart failure: a long-term multicenter randomized study. The Clinical Investigator; 71(8 Suppl), S134-S136.
Mortensen, S. A., Rosenfeldt, F., Kumar, A., Dolliner, P., Filipiak, K. J., Pella, D., & Littarru, G. P. (2014). The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized A 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.... Read more about this term trial. JACC. Heart Failure; 2(6), 641-649.
Zhai J, Bo Y, Lu Y, Liu C & Zhang L. (2017). Effects of Coenzyme Q10 on Markers of Inflammation: A Systematic Review and Meta-Analysis. PLoS One; 12(1): e0170172.
The information presented in this review article is not intended as medical advice and should not be used as such.
16 November 2019Please click here for more information about Coenzyme Q10 supplementation and heart health.