Effect of Coenzyme Q10 Supplementation on Cardiac Function and Quality of Life in Patients with Heart Failure: A Randomized Controlled Trial

<b>Background/Objectives:</b> Heart failure remains a complex syndrome with high morbidity and mortality, highlighting the urgent need for alternative treatments that address underlying bioenergetic impairments. CoQ10, which plays a crucial role in mitochondrial ATP production, has shown promising results in small studies, although larger trials are needed to confirm its efficacy. <b>Results:</b> This randomized controlled trial investigated the effects of coenzyme Q10 (CoQ10) supplementation on cardiac function and quality of life in heart failure patients. A total of 120 patients were randomly assigned to receive either CoQ10 (2 × 60 mg daily) or a placebo for six months. Baseline characteristics were similar between groups. The primary outcomes were changes in global longitudinal strain (GLS) and left ventricular ejection fractions (LVEFs), while secondary outcomes included improvements in functional capacity and quality of life. At the 6-month endpoint, the CoQ10 group showed significant improvements in GLS (-11.7% to -14.9%, <i>p</i> < 0.001), NT-proBNP levels (815.6 vs. 1378.5 pg/mL, <i>p</i> = 0.012), blood pressure, and 6 min walk test distance (349.3 vs. 267.0 m, <i>p</i> = 0.008) compared to the placebo group. LVEFs improved slightly in the CoQ10 group (38.9% to 40.6%, <i>p</i> = 0.170) but remained unchanged in the placebo group. <b>Conclusions:</b> These findings suggest that CoQ10 supplementation may improve cardiac function, reduce cardiac stress, and enhance functional capacity and quality of life in heart failure patients. Further research is needed to optimize dosage and identify the subgroups that may benefit most from CoQ10 therapy.