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

  1. Gerard T. Chew, MD1,
  2. Gerald F. Watts, DSC1,
  3. Timothy M.E. Davis, DPHIL1,
  4. Bronwyn G.A. Stuckey, MD1,2,
  5. Lawrence J. Beilin, MD1,
  6. Peter L. Thompson, MD1,
  7. Valerie Burke, MD1 and
  8. Philip J. Currie, MD3
  1. 1School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
  2. 2Keogh Institute for Medical Research, Nedlands, Western Australia, Australia
  3. 3Echo Services, Nedlands, Western Australia, Australia
  1. Corresponding author: Professor Gerald F. Watts, gwatts{at}meddent.uwa.edu.au

Abstract

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.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 16 May 2008.

    This study was funded by Solvay/Fournier. G.W. and T.D. have acted on advisory boards and delivered lectures for Solvay/Fournier. G.W., T.D., and B.S. were coinvestigators in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study.

    Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Received January 17, 2008.
    • Accepted May 13, 2008.
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  1. Published online before print May 16, 2008, doi: 10.2337/dc08-0118 Diabetes Care August 2008 vol. 31 no. 8 1502-1509
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