Hemodynamic Effects of Fenofibrate and Coenzyme Q₁₀ in Type 2 Diabetic Subjects With Left Ventricular Diastolic Dysfunction

• Published in: Diabetes care Vol. 31; no. 8; pp. 1502 - 1509
• Main Authors: Chew, Gerard T, Watts, Gerald F, Davis, Timothy M.E, Stuckey, Bronwyn G.A, Beilin, Lawrence J, Thompson, Peter L, Burke, Valerie, Currie, Philip J
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.08.2008
• Subjects: Adult; Aged; Biological and medical sciences; Blood Pressure - drug effects; Blood Pressure Monitoring, Ambulatory; Clinical Care/Education/Nutrition/Psychosocial Research; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes. Impaired glucose tolerance; Diabetic Angiopathies - blood; Diabetic Angiopathies - diagnostic imaging; Diastole - drug effects; diastolic blood pressure; Double-Blind Method; Echocardiography; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Fenofibrate - pharmacology; Fenofibrate - therapeutic use; Heart Rate; Humans; Hypolipidemic Agents - therapeutic use; image analysis; Male; Medical sciences; Metabolic diseases; Middle Aged; Miscellaneous; monitoring; noninsulin-dependent diabetes mellitus; Placebos; Public health. Hygiene; Public health. Hygiene-occupational medicine; systolic blood pressure; Ubiquinone - analogs & derivatives; Ubiquinone - pharmacology; Ubiquinone - therapeutic use; Ventricular Dysfunction, Left - blood; Ventricular Dysfunction, Left - diagnostic imaging; Heart; Endocrinopathy; Type 2 diabetes; Human; Nutrition; Fibrate derivatives; Cardiovascular disease; Metabolic diseases; Heart ventricle; Left ventricular failure; Antioxidant; Fenofibrate; Ubiquinone; Heart disease; Circulatory system; Hemodynamics; Left ventricle performance; Endocrinology; Antilipemic agent
• ISSN: 0149-5992; 1935-5548; 1935-5548
• DOI: 10.2337/dc08-0118

OBJECTIVE:--To investigate the effects of fenofibrate and coenzyme Q₁₀ (CoQ) on diastolic function, ambulatory blood pressure (ABP), and heart rate (HR) in type 2 diabetic subjects with left ventricular diastolic dysfunction (LVDD). RESEARCH DESIGN AND METHODS--We randomized, double-blind, 74 subjects to fenofibrate 160 mg daily, CoQ 200 mg daily, fenofibrate 160 mg plus CoQ 200 mg daily, or matching placebo for 6 months. Echocardiography (including tissue Doppler imaging) and 24-h ABP and HR monitoring were performed pre- and postintervention. RESULTS:--Neither fenofibrate nor CoQ, alone or in combination, altered early diastolic mitral annular myocardial relaxation velocity (E'), early-to-late mitral inflow velocity ratio (E/A), deceleration time, isovolumic relaxation time, or the ratio of early mitral flow velocity to early diastolic mitral annular myocardial relaxation velocity (E/E') compared with placebo (P > 0.05). Fenofibrate and CoQ interactively (P = 0.001) lowered 24-h systolic blood pressure (-3.4 ± 0.09 mmHg, P = 0.010), with a prominent nocturnal effect (-5.7 ± 1.5 mmHg, P = 0.006). Fenofibrate (-1.3 ± 0.5 mmHg, P = 0.013) and CoQ (-2.2 ± 0.5 mmHg, P < 0.001) independently lowered 24-h diastolic blood pressure. Fenofibrate reduced 24-h HR (-3.3 ± 0.5 beats/min, P < 0.001), but CoQ had no effect on HR. CONCLUSIONS:--In type 2 diabetic subjects with LVDD, neither fenofibrate nor CoQ, alone or in combination, improved diastolic function significantly. However, fenofibrate and CoQ independently and interactively lowered 24-h blood pressure, and fenofibrate alone reduced 24-h HR.