A double-blind, randomized placebo-controlled trial examining the effect of MitoQ on myocardial energetics in patients with dilated cardiomyopathy

作者：Brian P. Halliday, Ruth Owen, Aaraby Ragavan, Katherine L. Smith, Ben Statton, Alaine Berry, Alexandros Kasiakogias, Zoi Tsoumani, Mayooran Shanmuganathan, Jason Dungu, Antonio de Marvao, Upasana Tayal, James S Ware, Declan P. O’Regan, Dudley J. Pennell, John G.F. Cleland, Sanjay Prasad, John Gregson, Michael P. Murphy, Oliver J. Rider, Ladislav Valkovič · 发表于：European Heart Journal - Cardiovascular Imaging · 年份：2025 · DOI：10.1093/ehjci/jeaf310 · 被引用次数：4 · 研究领域：Cardiac Fibrosis and Remodeling、Mitochondrial Function and Pathology、Cardiovascular Function and Risk Factors

Oxidative stress may be an important driver of dilated cardiomyopathy (DCM) causing mitochondrial dysfunction and reduced ATP production, which mitochondria-targeted antioxidants, such as MitoQ may improve.1 We investigated whether MitoQ had an effect on myocardial energetics in patients with DCM using 31phosphorus magnetic resonance spectroscopy (31P-MRS) in a phase-2 randomized, double-blind, placebo-controlled trial. Participants provided written informed consent. The trial was approved by the National Research Ethics Committee (21/LO/0035) and registered on ClinicalTrials.gov (NCT05410873). Inclusion criteria were 1) patients with DCM, 2) LVEF ≤45% on two studies ≥3 months apart, 3) on guideline therapy for ≥3 months, 4) in sinus rhythm, 5) elevated NT-pro-BNP (>250 ng/L if >65 years, > 100 ng/L if ≤65 years). Exclusion criteria were 1) atrial fibrillation, 2) contraindication to CMR or gadolinium, 3) environmental trigger for DCM, 4) late gadolinium enhancement (LGE) > 25% 5) current cancer, 6) CoQ10 use and 7) cardiac device. Participants underwent CMR and 31P-MRS on a 3-Tesla scanner (Prisma, Siemens, Germany). Cardiac 31P-MRS was performed using a 20 cm loop transmit-receive coil (Pulse Teq, UK) and a 3-dimensional chemical shift imaging sequence.2 For skeletal muscle energetics, dynamic 31P-MRS was performed with a 15 cm loop transmit-receive coil (Pulse Teq, UK) over the vastus lateralis. With weights on the ankle, participants performed leg raises during two period...