Svend Aage Mortensen, M.D., Sc.D. (31 August 1942 – 22 April 2015) was a Danish cardiologist at

Rigshospitalet Rigshospitalet (meaning ''The National'', ''State'' or ''Hospital of the Realm'', but not usually translated) is the largest public and teaching hospital in Copenhagen and the most highly specialised hospital in Denmark. The hospital's main buildi ...

Copenhagen Copenhagen ( or .; da, København ) is the capital and most populous city of Denmark, with a proper population of around 815.000 in the last quarter of 2022; and some 1.370,000 in the urban area; and the wider Copenhagen metropolitan ar ...

Denmark ) , song = ( en, "King Christian stood by the lofty mast") , song_type = National and royal anthem , image_map = EU-Denmark.svg , map_caption = , subdivision_type = Sovereign state , subdivision_name = Danish Realm, Kingdom of Denmark ...

was until February 2017 the largest hospital in Denmark; only surpassed by

Skejby Sygehus Skejby Sygehus or Aarhus University Hospital, Skejby, was a university hospital in Aarhus, Denmark from 1988 to 2018. In 2011, Skejby Sygehus became part of Aarhus University Hospital Aarhus University Hospital (AUH) is a university hospita ...

, however, Rigshospitalet is a flagship in the Danish health care system. From 1990 until his death in 2015, Mortensen was the medical director of the heart transplantation unit at Rigshospitalet. He was a fellow of the European Society of Cardiologists. Mortensen is best known as the chief researcher and the leading author for the Q-Symbio study of the "Effect of

Coenzyme Q10 Coenzyme Q, also known as ubiquinone and marketed as CoQ10, is a coenzyme family that is ubiquitous in animals and most bacteria (hence the name ubiquinone). In humans, the most common form is coenzyme Q10 or ubiquinone-10. It is a 1,4-benzoq ...

on Morbidity and Mortality in

Chronic Heart Failure Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome, a group of signs and symptoms caused by an impairment of the heart's blood pumping function. Symptoms typically include shortness of breath, excessive fatigue, a ...

Coenzyme Q10 Research

Mortensen was one of the first researchers, along with Dr. Gian-Paulo Littarru, Dr. Per Langsjoen, and Dr. William V. Judy, to work with Dr.

Karl Folkers Karl August Folkers (September 1, 1906 – December 7, 1997) was an American biochemist who made major contributions to the isolation and identification of bioactive natural products. Career Folkers graduated from the College of Liberal Arts a ...

, who urged more research into the use of

as an

adjuvant treatment In pharmacology, an adjuvant is a drug or other substance, or a combination of substances, that is used to increase the efficacy or potency of certain drugs. Specifically, the term can refer to: * Adjuvant therapy in cancer management * Analgesi ...

for heart failure patients. The early collaboration with Dr. Folkers led to the development of a study protocol for the Q-Symbio Study. The Q-Symbio study was a multi-center, randomized,

double-blind In a blind or blinded experiment, information which may influence the participants of the experiment is withheld until after the experiment is complete. Good blinding can reduce or eliminate experimental biases that arise from a participants' expec ...

placebo-controlled Placebo-controlled studies are a way of testing a medical therapy in which, in addition to a group of subjects that receives the treatment to be evaluated, a separate control group receives a sham "placebo" treatment which is specifically designed ...

study that investigated the effectiveness of

adjunctive treatment Combination therapy or polytherapy is therapy that uses more than one pharmaceutical drug, medication or modality. Typically, the term refers to using multiple therapies to treat a ''single'' disease, and often all the therapies are pharmaceutical ...

of chronic heart failure patients with daily Coenzyme Q10 supplements in the

ubiquinone Coenzyme Q, also known as ubiquinone and marketed as CoQ10, is a coenzyme family that is ubiquitous in animals and most bacteria (hence the name ubiquinone). In humans, the most common form is coenzyme Q10 or ubiquinone-10. It is a 1,4-benzoq ...

form. The patients took 300 milligrams of

(100 milligrams three times daily, with meals) or matching

placebo A placebo ( ) is a substance or treatment which is designed to have no therapeutic value. Common placebos include inert tablets (like sugar pills), inert injections (like Saline (medicine), saline), sham surgery, and other procedures. In general ...

s for two years. The results from the Q-Symbio study showed significantly improved symptoms and survival for the patients taking the active

treatment together with their conventional

heart failure Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome, a group of signs and symptoms caused by an impairment of the heart's blood pumping function. Symptoms typically include shortness of breath, excessive fatigue, a ...

medications.

Multiple treatment options with Coenzyme Q10

As a cardiologist, Mortensen saw multiple treatment options with

cardiovascular disease Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). Other CVDs include stroke, h ...

: * As a prophylactic treatment in

statin Statins, also known as HMG-CoA reductase inhibitors, are a class of lipid-lowering medications that reduce illness and mortality in those who are at high risk of cardiovascular disease. They are the most common cholesterol-lowering drugs. Low- ...

therapy * As an

ischemic heart disease Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of atherosclerotic pla ...

and

angina pectoris Angina, also known as angina pectoris, is chest pain or pressure, usually caused by insufficient blood flow to the heart muscle (myocardium). It is most commonly a symptom of coronary artery disease. Angina is typically the result of obstru ...

* As a pretreatment for

coronary artery bypass surgery Coronary artery bypass surgery, also known as coronary artery bypass graft (CABG, pronounced "cabbage") is a surgical procedure to treat coronary artery disease (CAD), the buildup of plaques in the arteries of the heart. It can relieve chest pai ...

or valve surgery * As an

arterial hypertension Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high bl ...

* As a prophylactic treatment in

anthracycline Anthracyclines are a class of drugs used in cancer chemotherapy that are extracted from ''Streptomyces'' bacterium. These compounds are used to treat many cancers, including leukemias, lymphomas, breast, stomach, uterine, ovarian, bladder cance ...

therapy * As an

chronic heart failure Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome, a group of signs and symptoms caused by an impairment of the heart's blood pumping function. Symptoms typically include shortness of breath, excessive fatigue, a ...

New guidelines for the management of heart failure

Following the publication of the results of the Q-Symbio study, Mortensen urged that the

American College of Cardiology The American College of Cardiology (ACC), based in Washington, D.C., is a nonprofit medical association established in 1949. It bestows credentials upon cardiovascular specialists who meet its qualifications. Education is a core component of the ...

American Heart Association The American Heart Association (AHA) is a nonprofit organization in the United States that funds cardiovascular medical research, educates consumers on healthy living and fosters appropriate cardiac care in an effort to reduce disability and death ...

guidelines for the management of heart failure be revised to include

with the natural substance

. He summarized the case for Coenzyme Q10 as an adjunctive treatment for heart failure: * Safety: no serious side effects recorded in

randomized controlled trial A randomized controlled trial (or randomized control trial; RCT) is a form of scientific experiment used to control factors not under direct experimental control. Examples of RCTs are clinical trials that compare the effects of drugs, surgical te ...

s (RCT)s * Interactions: no definite drug interactions reported * Efficacy: ** RCTs: reduced hospitalizations and reduced mortality for heart failure patients **

Meta-analyses A meta-analysis is a statistical analysis that combines the results of multiple scientific studies. Meta-analyses can be performed when there are multiple scientific studies addressing the same question, with each individual study reporting me ...

of RCTs: improved left ventricular

ejection fraction An ejection fraction (EF) is the volumetric fraction (or portion of the total) of fluid (usually blood) ejected from a chamber (usually the heart) with each contraction (or heartbeat). It can refer to the cardiac atrium, ventricle, gall bladder, ...

and improved

NYHA The New York Heart Association (NYHA) Functional Classification provides a simple way of classifying the extent of heart failure. It places patients in one of four categories based on how much they are limited during physical activity; the limitati ...

class * Formulations: best

bio-availability In pharmacology, bioavailability is a subcategory of absorption and is the fraction (%) of an administered drug that reaches the systemic circulation. By definition, when a medication is administered intravenously, its bioavailability is 100%. Ho ...

of the Coenzyme Q10 when it is dissolved in vegetable oil and administered in capsules manufactured under pharmaceutical quality control

Coenzyme Q10 and the "energy starved heart"

Mortensen's research prior to the Q-Symbio study had convinced him of the importance of adequate Coenzyme Q10 for the heart muscle cells: * He knew that there is an

inverse correlation In statistics, there is a negative relationship or inverse relationship between two variables if higher values of one variable tend to be associated with lower values of the other. A negative relationship between two variables usually implies that ...

between the concentrations of

in the heart muscle tissue and the severity of heart failure. * He suspected that energy starvation of the

myocardium Cardiac muscle (also called heart muscle, myocardium, cardiomyocytes and cardiac myocytes) is one of three types of vertebrate muscle tissues, with the other two being skeletal muscle and smooth muscle. It is an involuntary, striated muscle that ...

(the "energy starved heart") is a dominant feature of heart failure; his research efforts were focused on finding a well-tolerated agent (Coenzyme Q10) to improve the energy and force of the heart muscle. * He liked the safe and positive way in which

improved heart function; Coenzyme Q10 as a medication did not block any neurohormonal responses in the heart. Instead, Coenzyme Q10 naturally enhanced the process of producing energy in the heart muscle cells. * He was aware that

medications inhibit not only the bio-synthesis of

cholesterol Cholesterol is any of a class of certain organic molecules called lipids. It is a sterol (or modified steroid), a type of lipid. Cholesterol is biosynthesized by all animal cells and is an essential structural component of animal cell mem ...

but also the bio-synthesis of Coenzyme Q10, thereby reducing the level of Coenzyme Q10 in the blood and in the heart muscle tissue.

Concern for heart failure patients

Mortensen's highest concern was the welfare of his heart failure patients and heart transplantation patients. He knew that heart failure is a disabling disease that diminishes the quality of life of the patients. It is a disease with an increasing prevalence. It is a disease that continues to have a poor prognosis even though advances have been made in various drug and medical device therapies. Mortensen's research established Coenzyme Q10 adjunctive treatment as a way to improve heart failure outcomes and break the

metabolic Metabolism (, from el, μεταβολή ''metabolē'', "change") is the set of life-sustaining chemical reactions in organisms. The three main functions of metabolism are: the conversion of the energy in food to energy available to run cell ...

vicious cycle in the heart muscle.

References

__FORCETOC__ {{DEFAULTSORT:Mortensen, Svend Aage 1942 births 2015 deaths