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Wyss C, Gündling PW, Kostev K. Real world effectiveness of Hawthorn special extract WS 1442 in a retrospective cohort study from Germany. Sci Rep 2024; 14:22986. [PMID: 39362947 PMCID: PMC11450181 DOI: 10.1038/s41598-024-74325-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 09/25/2024] [Indexed: 10/05/2024] Open
Abstract
Hawthorn special extract WS 1442 has beneficial effects on the cardiovascular system. Experimental studies have shown an antiarrhythmic effect of the substance. In the present study, we investigated antiarrhythmic effects of WS 1442 compared with magnesium/potassium in a large collective of outpatients. Using the IQVIA Disease Analyzer (DA) database, we included 4550 patients with a prescription of WS 1442 and 4550 matched patients with Tromcardin prescriptions (all registered products under the trademark Tromcardin that are magnesium and potassium supplementing foods for special medical purposes) who were followed for 5 years after the index date. The incidence of various cardiac arrhythmias (atrial fibrillation and flutter (AFF), tachycardia, and other cardiac arrhythmias) was recorded. Cox regression models were used to evaluate the potential association between both drugs and arrhythmias. The cumulative incidence of atrial fibrillation and flutter was significantly lower among patients with a prescription of WS 1442 compared to patients with magnesium/potassium prescriptions (10.8% vs. 16.4%, p < 0.001). WS 1442 prescription was significantly associated with a lower incidence of atrial fibrillation and flutter compared to magnesium/potassium (HR 0.71; 95% CI 0.64-0.80; p < 0.001). The cumulative incidence of tachycardia was significantly lower in the WS 1442 group compared to the magnesium/potassium group (8.3% vs. 9.4%, p < 0.001), similarly, the cumulative incidence of other cardiac arrhythmias was significantly lower among patients with WS 1442 compared to patients with magnesium/potassium (10.2% vs. 14.8%, p < 0.001). This study showed that in a large collective of outpatients, intake of hawthorn special extract WS 1442 was associated with a significantly lower incidence of atrial fibrillation, tachycardia, and other cardiac arrhythmias compared to magnesium/potassium, indicating its potential in treating and preventing such conditions.
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Affiliation(s)
| | | | - Karel Kostev
- Epidemiology, IQVIA, Unterschweinstiege 2-14, 60549, Frankfurt, Germany.
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Wyss CA. [Functional Heart Complaints]. PRAXIS 2023; 112:11-15. [PMID: 36597684 DOI: 10.1024/1661-8157/a003953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Functional Heart Complaints Abstract. Functional complaints often manifest as cardiac symptoms (palpitations, thoracic complaints, reduced performance, dyspnea). Prognostically relevant clinical situations must be identified or excluded through targeted diagnostics. In the absence of prognostically relevant diseases action is wanted only in the case of subjective suffering, which is significantly influenced by the patient's emotional processing of the experience. Various therapy options can be used to treat functional heart complaints (do nothing/ignore symptoms, optimal treatment of any underlying diseases, phytotherapy, antiarrhythmic drugs, interventional therapy, physical training, psychocardiological treatment, resilience strengthening etc.).
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Martinelli F, Perrone A, Yousefi S, Papini A, Castiglione S, Guarino F, Cicatelli A, Aelaei M, Arad N, Gholami M, Salami SA. Botanical, Phytochemical, Anti-Microbial and Pharmaceutical Characteristics of Hawthorn ( Crataegusmonogyna Jacq.), Rosaceae. Molecules 2021; 26:molecules26237266. [PMID: 34885847 PMCID: PMC8659235 DOI: 10.3390/molecules26237266] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/03/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022] Open
Abstract
Hawthorn (Crataegus monogyna Jacq.) is a wild edible fruit tree of the genus Crataegus, one of the most interesting genera of the Rosaceae family. This review is the first to consider, all together, the pharmaceutical, phytochemical, functional and therapeutic properties of C. monogyna based on numerous valuable secondary metabolites, including flavonoids, vitamin C, glycoside, anthocyanin, saponin, tannin and antioxidants. Previous reviews dealt with the properties of all species of the entire genera. We highlight the multi-therapeutic role that C. monogyna extracts could have in the treatment of different chronic and degenerative diseases, mainly focusing on flavonoids. In the first part of this comprehensive review, we describe the main botanical characteristics and summarize the studies which have been performed on the morphological and genetic characterization of the C. monogyna germplasm. In the second part, the key metabolites and their nutritional and pharmaceutical properties are described. This work could be an essential resource for promoting future therapeutic formulations based on this natural and potent bioactive plant extract.
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Affiliation(s)
- Federico Martinelli
- Department of Biology, University of Florence, 50019 Sesto Fiorentino, Italy; (F.M.); (A.P.)
| | - Anna Perrone
- Department of Biology, University of Florence, 50019 Sesto Fiorentino, Italy; (F.M.); (A.P.)
- Correspondence: (A.P.); (S.A.S.)
| | - Sanaz Yousefi
- Department of Horticultural Science, Bu-Ali Sina University, Hamedan 65178-38695, Iran; (S.Y.); (M.G.)
| | - Alessio Papini
- Department of Biology, University of Florence, 50019 Sesto Fiorentino, Italy; (F.M.); (A.P.)
| | - Stefano Castiglione
- Dipartimento di Chimica e Biologia, University of Salerno, 84084 Fisciano, Italy; (S.C.); (F.G.); (A.C.)
| | - Francesco Guarino
- Dipartimento di Chimica e Biologia, University of Salerno, 84084 Fisciano, Italy; (S.C.); (F.G.); (A.C.)
| | - Angela Cicatelli
- Dipartimento di Chimica e Biologia, University of Salerno, 84084 Fisciano, Italy; (S.C.); (F.G.); (A.C.)
| | - Mitra Aelaei
- Department of Horticulture, Faculty of Agriculture, University of Zanjan, Zanjan 45371-38791, Iran;
| | - Neda Arad
- School of Plant Sciences, The University of Arizona, Tucson, AZ 85721, USA;
| | - Mansour Gholami
- Department of Horticultural Science, Bu-Ali Sina University, Hamedan 65178-38695, Iran; (S.Y.); (M.G.)
| | - Seyed Alireza Salami
- Department of Horticultural Sciences, Faculty of Agricultural Science and Engineering, College of Agriculture and Natural Resources, University of Tehran, Karaj 31587-77871, Iran
- Correspondence: (A.P.); (S.A.S.)
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Raposo A, Saraiva A, Ramos F, Carrascosa C, Raheem D, Bárbara R, Silva H. The Role of Food Supplementation in Microcirculation-A Comprehensive Review. BIOLOGY 2021; 10:616. [PMID: 34356471 PMCID: PMC8301032 DOI: 10.3390/biology10070616] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/18/2021] [Accepted: 06/23/2021] [Indexed: 12/11/2022]
Abstract
(1) Background: Cardiovascular disease (CVD) is a major public health concern worldwide and a key cause of morbidity and mortality in developed countries. Accumulating evidence shows that several CVD forms are characterized by significant microcirculatory dysfunction, which may both cause and be caused by macrovascular disease, often preceding clinical manifestations by several years. Therefore, interest in exploring food supplements to prevent and restore microcirculation has grown. Given the continuous need to expand the available therapeutic arsenal for CVD, the food supplements market has recently grown and is expected to continue growing. (2) Methods: We provide an authoritative up-to-date comprehensive review of the impact of food supplementation on microcirculation by analyzing the European and American legal food supplements framework and the importance of food safety/food quality in this industry. We review the main literature about food bioactive compounds with a focus on microcirculation and some main food supplements with proven benefits. (3) Results: Despite a lack of scientific evidence, diet and microcirculatory function are clearly connected. The main food supplement examples in the literature with potential beneficial effects on microcirculation are: Ruscus aculeatus L., Centella asiatica L., Ginkgo biloba L., Salvia miltiorrhiza Bunge, Crataegus spp., Ginseng, Mangifera indica L., Aesculus hippocastanum L., Hamamelis virginiana L., and Vitis vinifera L. (4) Conclusions: Further clinical trials are necessary to better explore the effects of these food supplements.
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Affiliation(s)
- António Raposo
- CBIOS (Research Center for Biosciences and Health Technologies), Universidade Lusófona de Humanidades e Tecnologias, Campo Grande 376, 1749-024 Lisboa, Portugal
| | - Ariana Saraiva
- Department of Animal Pathology and Production, Bromatology and Food Technology, Faculty of Veterinary, Universidad de Las Palmas de Gran Canaria, Trasmontaña s/n, 35413 Arucas, Spain; (A.S.); (C.C.)
| | - Fernando Ramos
- Pharmacy Faculty, University of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal;
- REQUIMTE/LAQV, Rua Dom Manuel II, Apartado 55142, 4051-401 Oporto, Portugal
| | - Conrado Carrascosa
- Department of Animal Pathology and Production, Bromatology and Food Technology, Faculty of Veterinary, Universidad de Las Palmas de Gran Canaria, Trasmontaña s/n, 35413 Arucas, Spain; (A.S.); (C.C.)
| | - Dele Raheem
- Northern Institute for Environmental and Minority Law (NIEM), Arctic Centre, University of Lapland, 96101 Rovaniemi, Finland;
| | - Rita Bárbara
- School of Sciences and Health Technologies, Universidade Lusófona de Humanidades e Tecnologias, Av. Campo Grande 376, 1749-024 Lisbon, Portugal;
| | - Henrique Silva
- Research Institute for Medicines (iMed.ULisboa), Faculdade de Farmácia, Universidade de Lisboa, Av. Prof. Gama Pinto, 1649-003 Lisbon, Portugal
- Department of Pharmacy, Pharmacology and Health Technologies, Faculdade de Farmácia, Universidade de Lisboa, Av. Prof. Gama Pinto, 1649-003 Lisbon, Portugal
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Zhao Y, Wang X, Noviana M, Hou M. Nitric oxide in red blood cell adaptation to hypoxia. Acta Biochim Biophys Sin (Shanghai) 2018; 50:621-634. [PMID: 29860301 DOI: 10.1093/abbs/gmy055] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Indexed: 12/28/2022] Open
Abstract
Nitric oxide (NO) appears to be involved in virtually every aspect of cardiovascular biology. Most attention has been focused on the role of endothelial-derived NO in basal blood flow regulation by relaxing vascular smooth muscle; however, it is now known that NO derived from red blood cells (RBCs) plays a fundamental role in vascular homeostasis by enhancing oxygen (O2) release at the cellular and physiological level. Hypoxia is an often seen problem in diverse conditions; systemic adaptations to hypoxia permit people to adjust to the hypoxic environment at high altitudes and to disease processes. In addition to the cardiopulmonary and hematologic adaptations that support systemic O2 delivery in hypoxia, RBCs assist through newly described NO-based mechanisms, in line with their vital role in O2 transport and delivery. Furthermore, to increase the local blood flow in proportion to metabolic demand, NO regulates membrane mechanical properties thereby modulating RBC deformability and O2 carrying-releasing function. In this review article, we focus on the effect of NO bioactivity on RBC-based mechanisms that regulate blood flow and RBC deformability. RBC adaptations to hypoxia are summarized, with particular attention to NO-dependent S-nitrosylation of membrane proteins and hemoglobin (S-nitrosohemoglobin). The NO/S-nitrosylation/RBC vasoregulatory cascade contributes fundamentally to the molecular understanding of the role of NO in human adaptation to hypoxia and may inform novel therapeutic strategies.
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Affiliation(s)
- Yajin Zhao
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
| | - Xiang Wang
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
| | - Milody Noviana
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
| | - Man Hou
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
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Holubarsch CJF, Colucci WS, Eha J. Benefit-Risk Assessment of Crataegus Extract WS 1442: An Evidence-Based Review. Am J Cardiovasc Drugs 2018; 18:25-36. [PMID: 29080984 PMCID: PMC5772138 DOI: 10.1007/s40256-017-0249-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Preparations from Crataegus (hawthorn) have a long history in the treatment of heart failure. WS 1442 is a dry extract from hawthorn leaves with flowers (4–6.6:1), extraction solvent of ethanol 45% (w/w), adjusted to 17.3–20.1% of oligomeric procyanidins. Nonclinical studies show that WS 1442 has positive inotropic and antiarrhythmic properties and protects the myocardium from ischemic damage, reperfusion injury, and hypertension-related hypertrophy, improves endothelial functions such as NO synthesis, and delays endothelial senescence. Randomized, controlled trials in patients with heart failure have demonstrated that the herbal medicinal product increases functional capacity, alleviates disabling symptoms, and improves health-related quality of life, all of which have become important targets of heart failure therapy according to current disease management guidelines. Clinical trials (including a 2-year mortality study with polypharmacy and > 1300 patients exposed) and post-marketing surveillance studies have shown that WS 1442 has a very favorable safety profile both as monotherapy and as add-on therapy, where no drug interactions have been observed. No specific adverse reactions to WS 1442 are known to date. WS 1442 may thus help to close the therapeutic gap between systolic and diastolic heart failure for which evidence of efficacy for other cardioactive drugs is sparse. Scientific evidence shows that WS 1442 is safe and has a beneficial effect in patients with heart failure corresponding to New York Heart Association classes II or III. The benefit-risk assessment for WS 1442 is therefore positive.
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Alp H, Soner BC, Baysal T, Şahin AS. Protective effects of Hawthorn (Crataegus oxyacantha) extract against digoxin-induced arrhythmias in rats. Anatol J Cardiol 2014; 15:970-5. [PMID: 25880053 PMCID: PMC5368468 DOI: 10.5152/akd.2014.5869] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2014] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Digitalis preparations are commonly used by children and adults with heart diseases worldwide, although excessive doses may cause cardiac effects. The aim of the study is to evaluate the antiarrhythmic effect of Crataegus oxyacantha extract on digoxin-induced arrhythmias in anesthetized Wistar rats. METHODS Control and experimental groups were evaluated for arrhythmias induced by digoxin. Fifteen rats (7 as controls and 8 as the experimental group) were included in the study. The dry fruits of 100 mg Crataegus oxyacantha were extracted by percolation method. Digoxin, at a dose of 40 µg/kg/min, was infused to form the arrhythmias in all rats. Simultaneously, the extract was infused into the experimental group, while 0.9% NaCl was infused into control group. Electrocardiographic QRS prolongation and arterial blood pressure changes were analyzed. RESULTS The experimental group lived longer (62.13±2.20 min) than the controls (p=0.002). On the other hand, the time to beginning of QRS prolongation did not differ between the two groups (p=0.812). Bradycardia was significant in the control group (288.01±10.54 beat/min and p=0.01). The maximum QRS duration was observed in the control group during the digoxin and 0.9% NaCl infusion period (53.29±3.99 ms and p=0.001). Also, the durations of atrial and ventricular arrhythmias were shorter in the experimental group. However, arterial blood pressure dipping was significant in the experimental group (23.67±10.89 mm Hg and p<0.001). CONCLUSION Crataegus oxyacantha alcoholic extract produced an antiarrhythmic effect that was induced by digoxin in Wistar rats. However, in the clinical use of this extract, the hypotensive effect should be considered. Also, the alcoholic extract of Crataegus oxyacantha may be an alternative treatment medication for arrhythmias induced by digoxin toxicity in humans.
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Affiliation(s)
- Hayrullah Alp
- Department of Pediatric Cardiology, Malatya State Hospital, Malatya-Turkey.
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Effects of Endurance Exercise Training and Crataegus Extract WS® 1442 in Patients with Heart Failure with Preserved Ejection Fraction – A Randomized Controlled Trial. Sports (Basel) 2014. [DOI: 10.3390/sports2030059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Effect of crataegus usage in cardiovascular disease prevention: an evidence-based approach. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:149363. [PMID: 24459528 PMCID: PMC3891531 DOI: 10.1155/2013/149363] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Accepted: 11/24/2013] [Indexed: 12/14/2022]
Abstract
Hawthorn (Crataegus oxyacantha) is a widely used Chinese herb for treatment of gastrointestinal ailments and heart problems and consumed as food. In North America, the role of treatment for heart problems dates back to 1800. Currently, evidence is accumulating from various in vivo and in vitro studies that hawthorn extracts exert a wide range of cardiovascular pharmacological properties, including antioxidant activity, positive inotropic effect, anti-inflammatory effect, anticardiac remodeling effect, antiplatelet aggregation effect, vasodilating effect, endothelial protective effect, reduction of smooth muscle cell migration and proliferation, protective effect against ischemia/reperfusion injury, antiarrhythmic effect, lipid-lowering effect and decrease of arterial blood pressure effect. On the other hand, reviews of placebo-controlled trials have reported both subjective and objective improvement in patients with mild forms of heart failure (NYHA I-III), hypertension, and hyperlipidemia. This paper discussed the underlying pharmacology mechanisms in potential cardioprotective effects and elucidated the clinical applications of Crataegus and its various extracts.
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