Lege Artis Medicinae

[Experience with coenzyme Q10 in heart failure]

KOHUT László

SEPTEMBER 20, 2011

Lege Artis Medicinae - 2011;21(08-09)

[INTRODUCTION - The protein complex coenzyme Q10 (CoQ10) has a role in ATP production as a mitochondrial electron transport molecule, and it also has a strong antioxidant effect. Several studies have proved the correlation between the decrease in CoQ10 level and the severity of heart failure. Heart failure is a multifactorial syndrome, the development of which is greatly influenced by an abnormal energy metabolism. CASE REPORT - The 61-year-old woman developed heart failure after a myocardial infarction. She complained of fatigue, dyspnoea and reduced physical endurance even with optimal treatment. When her therapy was completed by CoQ10, her endurance and life quality significantly improved and her symptoms ameliorated. CONCLUSIONS - Medical treatment of chronic heart failure is an evidence-based, complex therapy. Despite the complex management, morbidity and mortality of this condition remain high. A number of studies have shown that CoQ10 substitution can improve the clinical and haemodynamical parameters of patients with heart failure. On the basis of these results, the use of CoQ10 as an adjuvant therapy to complex treatment has an increasing role.]



Further articles in this publication

Lege Artis Medicinae

[Empirical versus preemptive antifungal therapy of invasive fungal infections in patients with oncohaematological diseases]


[Fungal infections present a significant problem among immunocompromised patients. The essence of empirical antifungal therapy is to collect data, physical signs and symptoms that confirm the clinically suspected invasive fungal infections and enable initiation of antifungal therapy. With the improvement of early diagnosis of invasive fungal infactions, the diagnosisdrived application of antifungal preparations has been re-evaluated. However, no consensus exists to date regarding preemptive antifungal therapy. After evaluating the benefits and potential side effects of the therapy, the relevant centers decide whether the preemptive or the empirical method should be preferred.]

Lege Artis Medicinae

[Efficacy and safety of ciclesonide in patients with severe asthma]


Lege Artis Medicinae

[The development of insulin treatment from discovery of insulin to analogue preparations]

KÁPLÁR Miklós, PARAGH György

[The discovery of insulin was a milestone in the treatment of diabetes mellitus. Animalderived (porcine and cattle) insulins available at the beginning were later replaced by human insulins. Recently, analogue insulins are the most widespreadly used. Besides the increase in the quantity and improvement in the quality of the insulin products, the growth of the treatment regimes is apparent, as well. That varies from the once-given daily basal insulin treatment added to oral antidiabetic drugs to intensified insulin therapy, administering insulin 4-5 times daily. Considering the benefits proved by previous basic and clinical studies, the authors summarize the most important properties of the commonly used insulin treatment regimes in this review. They also briefly outline the important aspects of the patient-centered personalized therapy and the connection between insulin therapy and carcinogenesis.]

Lege Artis Medicinae

[Every Day is a Gift – An Interview with Imre Romics by Elemér Nemesánszky]


Lege Artis Medicinae

[The role of measuring galactomannan in the modern therapy of invasive aspergillosis]


[Invasive aspergillosis is a life threatening mycosis prevalent in groups of patients with specific risk factors. To establish the diagnosis a specimen for histological examination has to be obtained. However, the vast majority of patients are not suitable for biopsy or this procedure can only be performed late in the course of the disease. Current diagnostic workup is based on high resolution thoracic CT scans and serum galactomannan antigen testing. Antigen detection can either be used for screening to detect early phase infection or to prove the full-blown disease. Here clinical aspects of galactomannan antigen testing and its role in current management of aspergillosis are reviewed.]

All articles in the issue

Related contents

Clinical Neuroscience

[Vinpocetin in neurological diseases]

SZAPÁRY László, KÉSMÁRKY Gábor, TÓTH Kálmán, MISNYOVSZKY Melinda, TÓTH Tímea, BALOGH Ágnes, NAGY Krisztián, NÉMETH György, FEHÉR Gergely

[Introduction - Stroke is the third leading cause of death worldwide (following cardiovascular and cancer mortality) and associated with serious disability for the vast majority of patients. There is no salvage therapy for irreversibly damaged brain areas, improving the circulation of the surrounding hypoperfused territories may be associated with benefitial clinical states. Cerebral hypoperfusion may play a role in the pathogenesis of other kind of neurological diseases, improvement of global circulation may have a preventive effect on these conditions. Aims - The aim of our study was to review the experimental and clinical articles focusing on the role of vinpocetin in different neurological conditions. Results - Vinpocetin appears to have several different mechanisms of action that allow for its antiinflammatory, antioxidant, vasodilating, antiepileptic and neuroprotective activities in experimental conditions. On the other hand, several meta-analysis of the existing studies in acute stroke examining short and long term fatality rates with vinpocetin was unable to assess efficacy. In chronic cerebrovascular patients, vinpocetin improves impaired hemorheological variables, has significant vasodilating properties, improves endothelial dysfunction, neuroimaging studies showed selective increase in cerebral blood flow and cerebral metabolic rate, all of which are potentially beneficial in cerebrovascular disease and may improve cognitive functions. Summary - Based on the above mentioned results vinpocetin plays an important role both in basic research and in clinical management of different neurological diseases.]

Clinical Neuroscience

[Current medical aspects of pantethine (in English language)]


[Pantethine, the stable disulfide form of pantetheine, is the major precursor of coenzyme A, which plays a central role in the metabolism of lipids and carbohydrates. Coenzyme A is a cofactor in over 70 enzymatic pathways, including fatty acid oxidation, carbohydrate metabolism, pyruvate degradation, amino acid catabolism, haem synthesis, acetylcholine synthesis, phase II detoxification, acetylation, etc. Pantethine has beneficial effects in vascular disease, it able to decrease the hyperlipidaemia, moderate the platelet function and prevent the lipid-peroxidation. Moreover its neuro-endocrinological regulating role, its good influence on cataract and cystinosis are also proved. This molecule is a well-tolerated therapeutic agent; the frequency of its side-effect is very low and mild. Based on these preclinical and clinical data, it could be recommended using this compound as adjuvant therapy.]

Lege Artis Medicinae

[Differential diagnosis and treatment of hyponatraemia]

NÉMETH Zsófia, DEÁK György

[Hyponatraemia (serum sodium concentration < 136 mmol/l) is the most frequent electrolyte abnormality that inceases the risk of both in-hospital, and outpatient mortality. Antidiuretic hormone action or low glomerular fitration rate or low excretable osmoles or their combination are involved in its pathogenesis. Differential diagnosis is based on medical and medication histories, serum- and urine osmolality and urine sodium concentration. Measurement of fractional excretions of urea and uric acid help identifying low effective circulting volume, renal hypoperfusion. Symptomatic hyponatraemia or an acute decrease of serum sodium concentration exceeding 10 mmol/l should be treated with 3% NaCl to avoid impending threat to life. The principles of the treatment of chronic hyponatraemia are restriction of water intake and elimination of etiologic factor(s) (eg. medications - most often thiazides). In case of contracted axtracellular volume, isotonic saline should be given. In case of euvolaemia, restriciton of water intake is fundamental. In case of expanded extracellular volume, (heart failure, liver cirrhosis, nephrosis), water and NaCl intake should be restricted along with aldosteron antagonist and loop diuretic therapy. In chronic hyponatraemia, the rise of serum sodium concentration should not exceed 10 mmol/l during the first 24 hours and 8 mmol/l/day thereafter. ]

Lege Artis Medicinae

[Effect of beta blockers in hypertension, ischaemic heart disease, heart failure and metabolic syndrome]


[Beta-blockers are among the most widely used drugs for the treatment of cardiovascular diseases. In the mid-90’s, these drugs were recommended as first-line therapies of hypertension. With the introduction of new drugs, the list of first-choice drugs has been extended. The results of recently published major hypertension trials, which compared conventional agents (beta blockers and/or diuretics) with newer agents (angiotensin converting enzyme inhibitors, Caantagonists, angiotensin receptor blockers), raised concerns regarding the role of beta blockers in cardiovascular primary prevention. Subsequently, a metaanalysis of 13 trials has shown that compared with other drug types, beta-blocker therapy is less beneficial in patients with hypertension who do not have heart disease. Nevertheless, in cardiovascular indications other than hypertension (acute myocardial infarction, heart failure and arrhythmias), betablockers retain their dominant position.]

Lege Artis Medicinae



[A hypertonia korszerű kezelésében a szelektív α1-adrenoreceptor-antagonisták ma is jelentős szerepet játszanak. A hatékony vérnyomáscsökkentés mellett számos előnyös, járulékos hatásuk révén sok társbetegséget (diabetes mellitus, atherogen dyslipidaemia, obliteratív érbetegség, prostatahypertrophia, erectilis diszfunkció) is kedvezően befolyásolnak. A hypertoniához társuló szívelégtelenségben, illetve annak elkerülése érdekében monoterápiában nem alkalmazhatók. Az α1-adrenoreceptor-antagonisták kombinációja diuretikummal mindig javasolt.]