HEMODYNAMIC EFFECTS OF FENOFIBRATE AND COENZYME Q10 IN TYPE 2 DIABETIC SUBJECTS WITH LEFT VENTRICULAR DIASTOLIC DYSFUNCTION
- Gerard T Chew, MD (Hons)1,
- Gerald F Watts, DSc (gwatts{at}meddent.uwa.edu.au)1,
- Timothy ME Davis, DPhil1,
- Bronwyn GA Stuckey, MD1,,2,
- Lawrence J Beilin, MD1,
- Peter L Thompson, MD1,
- Valerie Burke, MD1 and
- Philip J Currie, MD3
- 1School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, AUSTRALIA
- 2Keogh Institute for Medical Research, Nedlands, Western Australia, AUSTRALIA
- 3Echo Services, Nedlands, Western Australia, AUSTRALIA
Abstract
Objective: To investigate the effects of fenofibrate and Coenzyme Q10 (CoQ) on diastolic function, ambulatory blood pressure (BP) and heart rate (HR) in type 2 diabetic (T2DM) subjects with left ventricular diastolic dysfunction (LVDD).
Research Design And Methods: 74 subjects were randomized, double-blind, to fenofibrate 160mg daily, CoQ 200mg daily, fenofibrate 160mg plus CoQ 200mg daily, or matching placebo for six months. Echocardiography (including tissue Doppler imaging) and 24-hour ambulatory BP and HR monitoring were performed pre- and post-intervention.
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 E/E‵ compared with placebo (p>0.05). Fenofibrate and CoQ interactively (p=0.001) lowered 24-hour systolic BP (−3.4±0.09mmHg, p=0.010), with a prominent nocturnal effect (−5.7±1.5mmHg, p=0.006). Fenofibrate (−1.3±0.5mmHg, p=0.013) and CoQ (−2.2±0.5mmHg, p<0.001) independently lowered 24-hour diastolic BP (DBP). Fenofibrate reduced 24-hour HR (−3.3±0.5 beats/min, p<0.001) but CoQ had no effect on HR.
Conclusions: In T2DM subjects with LVDD, neither fenofibrate nor CoQ, alone or in combination, improved diastolic function significantly. However, fenofibrate and CoQ independently and interactively lowered 24-hour BP, and fenofibrate alone reduced 24-hour HR.
Footnotes
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- Received January 17, 2008.
- Accepted May 13, 2008.
- Copyright © American Diabetes Association
