NMN and CoQ10 Can Minimize Irregular Heartbeats Following a Heart Attack

Highlights

• The combination of NMN and CoQ10 decreased the severity and frequency of irregular heartbeats after a heart attack in aged rats.
• The NMN and CoQ10 combination also improved levels of several indicators of heart stress and damage.

New research has pointed to a simple way to get the heart to maintain a healthy and normal rhythm after a heart attack, which becomes increasingly worse with aging. Scientists from Tabriz University of Medical Sciences found that ubiquinol (a type of coenzyme Q10; CoQ10) and nicotinamide mononucleotide (NMN) may work well together to help keep the heart healthy as people age and protect against damage after a heart attack, which gets worse with age. The research, which was led by heart health expert Dr. Reza Badalzadeh, shows that giving NMN and ubiquinol to old mice makes their irregular heartbeats less common, last shorter, and be less severe after a heart attack. Based on these results, combination therapies may be better able to handle the complicated nature of heartbeats that are not regular after a heart attack. They also have a better chance of being used in clinical settings to treat heart conditions.

Course-correcting heart rhythm

After a heart attack, the first thing that needs to be done to get the heart working normally again is to clear out any clogged arteries or blood vessels so that the heart can get the blood it needs. But reperfusion, the process of getting blood back to the heart, is only half the battle. After reperfusion, there’s a secondary effect that puts the heart under a considerable amount of duress that can lead to fatal irregular heartbeats, known as arrhythmias. Within seconds of reperfusion, the heart quickly releases molecules that put a lot of stress on the heart and reduces other molecules that are necessary for the heart to work properly.

This can lead to sudden and isolated arrhythmias. One family of molecules that cause stress is known as reactive oxygen species (ROS), and molecules that fight them are called antioxidants.

But if excessive levels of ROS persist, the heart can start to have irregular heartbeats that become permanent. Getting the heart back to a healthier state after a heart attack includes blocking these stress-related molecules to stop arrhythmias and increasing the ones that are needed to keep the heart beating steadily and without disruption.

NMN and CoQ10 improve heartbeat after an attack

With all of these things in mind, Behnaz Mokhtari and her colleagues decided to see if a mix of molecules could protect aged mice from arrhythmias after a heart attack. A number of factors led Mokhtari and colleagues to focus on NMN and ubiquinol. Firstly, the amounts of NMN and ubiquinol in the heart drop significantly with age and after a heart attack. This causes stress and gradual damage to mitochondria, which are cells’ power plants and very important for heart cell function. Second, NMN helps make NAD+ and boosts the body’s antioxidant defenses. Ubiquinol, on the other hand, protects mitochondrial function and lowers ROS production.

The research looked at what happened to older mice’s hearts when they were subjected to ischemia-reperfusion injury, a process that mimics a heart attack, and how NMN and ubiquinol affected them before and after the injury. When used by themselves, NMN or ubiquinol slightly decreased the number and length of irregular heartbeats, but the differences were not significant. But when they were taken together, they greatly decreased the number and length of irregular heartbeats, especially the worst kind, which in some cases went away completely.

The results were similar when it came to testing the heart’s function. The combined treatment made several standard measures of heart function much better than the aged rats that were not treated or those that only received single treatments. These measures included heart contraction and blood pumping.

When the researchers looked more closely at the heart for damage, they saw that NMN alone slightly lowered levels of molecules that showed heart cell damage. However, when NMN and ubiquinol were combined, the levels dropped much more significantly, showing stronger protective effects. When looking at molecules connected to cell stress, the same pattern was seen: the different treatments did not do much to lower the levels of ROS and did not do much to raise the levels of antioxidants.

In contrast, the combined treatment lowered ROS levels and signs of cell stress while increasing the activities of antioxidant enzymes. Lastly, the aged rats’ levels of nitric oxide, a molecule important for heart function, only got better when they were given NMN and ubiquinol together before the fake heart attack.

These results suggest that NMN and ubiquinol do not do much good for aging hearts when used alone, but when they work together, they make the heart work better, lower stress, and protect cells from damage. According to the researchers, getting older may make single therapies less effective by messing up the function of mitochondria and other protective pathways. Using NMN (as a preconditioning agent) and ubiquinol (as a postconditioning agent) together seems to get around these problems, making it a better way to protect older hearts from ischemia reperfusion injury. More research is needed to figure out how these improved protective effects work.

What’s next?

More research needs to be done on how NMN and ubiquinol work together to help the body heal after blood flow is cut off. Examining heart tissue for changes like scarring, structural damage, and cell responses during this later phase could show if the treatment helps prevent long-term damage and supports healing after the initial injury.

Also, Mokhtari and his colleagues only tested the treatment on male rats, so it is not clear how well it works for female rats. It is possible that important differences between how hearts of males and females react to the treatment were missed. Future studies should include both male and female animals to address this gap.

Further research should also investigate how NMN and ubiquinol affect processes critical to a stable heartbeat, including how the cells in the heart work individually and as a group. So, while the results are promising, more research is needed to fully understand how this combination works to protect against irregular heart rhythms.