The enzyme Q10 (ubiquinone), a quinine, was discovered in 1957, and since that time there has been considerable controversy regarding its use in heart failure and other forms of heart disease. This enzyme serves as a mitocho-ndrial enzyme supplement and appears to improve defective myocyte energetics in patients with heart failure. Coenzyme Q10 plays an intermediary role in the electron transport chain during the oxidation of reduced nicota-mide adenine dinucleotide (NADH) or succinate, with the conversion of oxygen to water within the mitochondria (see Fig. 1). This enzyme is involved in electron proton transfer during oxidative phosphorylation. Also, coenzyme Q10 possesses antioxidant, free radical scavenging, and membrane stabilizing properties.
There is no doubt that myocyte energetics and mitochondrial function is severely deranged in patients with heart failure and salutary cardioactive agents are wanting. There have been major advances in the manage¬ment of heart failure during the past decade, but the epidemic of heart failure continues worldwide. To stop this epidemic, it is crucial that new cardioactive agents are found.