I am very glad to hear from you, and your doing fine
Exercising is very important so please try to make some time for it
About the Q10 and the amino acids, yes you must resume them again, they are the most important of the whole protocol.If you don`t your EF is getting worse.
Strengthening the Heart Muscle: The Power of CoQ10
Studies have shown that nutrients and supplements can strengthen the heart muscle, with fewer side effects than the powerful pharmaceuticals often used to treat the condition. CoQ10 is one of the most powerful.
The goal with nutrients and supplements is the same as with conventional medication: to slow the gradual enlargement and weakening of the heart. This process, which occurs in all forms of CHF, is called cardiac remodeling. During cardiac remodeling, the heart gradually changes shape, becoming larger and thinner. Cardiac remodeling is the driving force behind the reduced quality of life experienced by patients with CHF (Fedak PW et al 2005; Weisberg AD et al 2005).
By reinforcing the heart's function, it may be possible to slow cardiac remodeling. In this regard, CoQ10 has been studied since the middle 1960s. Present in high quantities throughout the heart muscle, CoQ10 has many beneficial effects, including energy production (Awata N et al 1980; Crane FL et al 1997; Nakamura Y et al 1982; Nayler WG 1980), an antioxidant effect (Frei B et al 1990), and stabilizing the heart membrane (Ondarroa M et al 1986).
The following studies have examined CoQ10 in CHF and found that it can improve heart function:
One meta-analysis looked at all the published studies between 1966 and 2005 of CoQ10 in CHF. It found that CoQ10 had an overall value in improving ejection fraction and diastolic volume. Although the authors called for more large studies to confirm these results, they noted that CoQ10 is generally well tolerated, with few side effects (Weant KA et al 2005).
Researchers reviewed clinical trials involving 1,000 patients with CHF and found a significant improvement in exercise tolerance and a reduced NYHA class among those receiving CoQ10 (Mortensen SA 2003).
A study of 32 patients with NYHA class IV CHF who were waiting for a heart transplant showed improved cardiac function and a reduction of symptoms after CoQ10 supplementation (Berman M et al 2004).
Among patients with CHF who had a low ejection fraction (of less than 45 percent) and an elevated left ventricular diastolic volume, CoQ10 has been shown to reduce diastolic volume, which is associated with increased survival among patients undergoing coronary artery bypass surgery (Jeejeebhoy F et al 2002). The degree of benefit associated with CoQ10 among these patients was shown to correlate to the severity of their CHF (Taggart DP et al 1996).
Other studies have shown that withdrawing CoQ10 from patients with CHF resulted in decreased cardiac function and more severe symptoms (Judy WV et al 1991).
Increasing Energy and Blood Flow and Reducing Swelling: L-Carnitine and Taurine
Like CoQ10, the levels of L-carnitine and taurine in the heart muscle have been shown to decline among patients with CHF. By raising blood levels of both amino acids, patients with CHF have responded with fewer symptoms and improved cardiac function.
L-carnitine is essential for the transport of fatty acids into the heart muscle and mitochondria for energy production and is sensitive to the level of oxygen in the heart muscle. Studies have shown that patients with CHF who take L-carnitine have improved ejection fraction (Goa KL et al 1987; Mancini M et al 1992; Pucciarelli G et al 1992). There is evidence that L-carnitine helps the heart by preventing the enlargement of the left ventricle, which is a critical step in the progression of CHF. Studies have shown that L-carnitine can help prevent left ventricular enlargement after bypass surgery in patients who have had a heart attack (Taggart DP et al 1996). The same results were found among patients who have had an acute heart attack (Colonna P et al 2000). By improving ejection fraction and preventing enlargement of the left ventricle, L-carnitine addresses two of the most serious problems associated with CHF.
Taurine acts by a different mechanism. Patients with CHF often have swelling caused by excessive fluid buildup in the tissues, which puts additional pressure on the heart and accelerates CHF. Diuretics, one of the standard pharmaceutical therapies in CHF, are basically designed to flush excess fluid from the body. Taurine, through well-documented pathways, has a similar effect and has been shown to help reduce fluid levels, reducing the workload on the heart (Schaffer SW et al 2000).
Taurine has a number of other positive influences as well, including minimizing the effect of the protein angiotensin II (Schaffer SW et al 2000). Angiotensin II causes blood vessels to constrict. This is the same protein targeted by ACE inhibitors, which are a mainstay of conventional CHF treatment. By minimizing the effect of angiotensin II, taurine may reduce cardiac remodeling (Schaffer SW et al 2000).
Yes it is safe to take the MSM for a very long time,