拡張型心筋症に対するCoenzyme Q10の慢性効果—心エコー法による検討

The chronic effect of coenzyrne Q10 for dilated cardiomyopathy:Echocardiographic assessment

　拡張型心筋症（以下DCMと略す）は原因不明の収縮能低下をきたす予後不良の疾患であるが，その一因にと同時に，心筋代謝賦活剤による代謝面からの改善も試みられている。1957年Craneら^1）によりウシの心筋のミトコンドリアから分離され，Lesterら^2）によりCoen—zyme Q （以下CoQと略す）と名づけられた補酵素は，電子伝達系に関与して細胞呼吸に重要な役割を持ち，ヒトでは側鎖のイソプレノイド基の数nが10であるため，Coenzyme Q₁₀（CoQ₁₀）と呼ばれる。心不全患者ではこのCoQの心筋での欠乏^3）が報告されており，また心不全に対するCoQの臨床的有用性も数多く報告されている^4〜9）。

　我々は心不全をきたす疾患のうちでも最も予後不良な疾患の1つであるDCMに対するCoQ₁₀の有用性を心エコー法を用いて検討した。

To evaluate the chronic effect of coenzyme Q₁₀ (CoQ₁₀) to dilated cardiomyopathy (DCM), sixteen patients with DCM were studied by echocardio-graphy. Seven of sixteen patients were received CoQ₁₀ 45 mg per day for five months (CoQ₁₀ group). Nine of them were followed without CoQ₁₀, for five months (non-CoQ₁₀ group). Blood pressure and heart rate were not significantly changed in both groups. In echocardiographic findings, left ventricular end-diastolic dimension (Dd) was not significantly changed, end-systolic dimension (Ds) was increased from 52±5 mm to 55±6 mm and percent fractional shortening (%FS) decreased from 22±5% to 18±6% (p<0.05) in non-Co₁₀ group. In CoQ₁₀ group, Dd and Ds tended to increase slightly (n. s.) and %FS tended to increase (21±5% to 23±5%, n. s.). Although symptom of heart failure was deteriorated in three of nine patients in non-CoQ₁₀ group, it was aggra-vated in one and was improved in two of seven patients in CoQ₁₀ group. That is to say, although in non-CoQ₁₀ group cardiac contractility decreased progressively for five months, it was not significantly changed in CoQ₁₀ group. These results suggested that CoQ₁₀ might prevent the progression of my-ocardial lesion in DCM.