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Ahn JY, Chu H, Leem J, Yun JM. Effectiveness and safety of traditional herbal medicine on cardiac arrhythmic condition: A systematic review and meta-analysis of randomized control clinical trial. Medicine (Baltimore) 2024; 103:e38441. [PMID: 38847675 PMCID: PMC11155608 DOI: 10.1097/md.0000000000038441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 05/10/2024] [Indexed: 06/10/2024] Open
Abstract
INTRODUCTION The prevalence of cardiac arrhythmia, which can lead to cardiac death, heart failure, and cardioembolic stroke, is increasing. Although various Western medicines for cardiac arrhythmias have been developed, there are still various difficulties in the management of arrhythmias. Traditional herbal medicines (THM) are widely used to manage arrhythmia in East Asia. Therefore, this study aimed to assess the effectiveness and safety of THM in the treatment of arrhythmia. METHOD Using a systematic review methodology, we searched for randomized clinical trials on herbal medicines for arrhythmia without complications in 4 databases up to September 2022. The literature search was carried out again, targeting papers published until April 2024.We conducted a risk-of-bias assessment and meta-analysis. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS Eighty-two randomized clinical trials were included in this meta-analysis. Total effective rate was significantly better in unspecified arrhythmia (risk ratio [RR]: 1.20, 95% confidence interval [CI]: 1.13-1.26), premature ventricular contraction (RR: 1.29, 95% CI: 1.29-1.33), sinus bradycardia (RR: 1.26, 95% CI: 1.17-1.36), tachycardia (RR: 1.23 95% CI: 1.15-1.32), and atrial fibrillation (RR: 1.17, 95% CI: 1.07-1.27). No severe adverse events were associated with THM. The overall risk of bias was relatively high. The total effective rate was the most frequently assessed clinical outcome variable. Most outcomes were surrogates and not clinical endpoints. CONCLUSION THM, alone or in combination with Western medicine, has therapeutic effects on cardiac arrhythmic diseases. However, additional disease-specific clinical outcome variables are required for further studies on THM. Owing to the low quality of the included studies and their small sample sizes, additional large-scale, long-term follow-up, and well-designed randomized controlled clinical trials are required. SYSTEMATIC REVIEW REGISTRATION NUMBER Details of the protocol for this systematic review and meta-analysis were registered on the Open Science Framework (OSF. io). (https://osf.io/7r8kn/).
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Affiliation(s)
- Jae-yoon Ahn
- Department of Korean Internal Medicine, College of Korean Medicine, Wonkwang University, 460, Iksan-daero, South Korea
| | - Hongmin Chu
- Department of Diagnostics, College of Korean Medicine, Wonkwang University, 460, Iksan-daero, South Korea
| | - Jungtae Leem
- Department of Diagnostics, College of Korean Medicine, Wonkwang University, 460, Iksan-daero, South Korea
- Research Center of Traditional Korean Medicine, College of Korean Medicine, Wonkwang University 460, Iksan-daero, South Korea
| | - Jong-Min Yun
- Department of Korean Internal Medicine, College of Korean Medicine, Wonkwang University, 460, Iksan-daero, South Korea
- Research Center of Traditional Korean Medicine, College of Korean Medicine, Wonkwang University 460, Iksan-daero, South Korea
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Wan-Tong Z, Bao-Chen Z, Zhao L, Xu-Jie W, Rui G, Ning X, Wei T, Yu-Fei W, Miles P, Wei-Liang W, Hao-Xiang L, Qiu-Yan L. Compassionate Use of Yuanjiang Decoction, a Traditional Chinese Medicinal Prescription, for Symptomatic Bradyarrhythmia. Front Pharmacol 2022; 13:764930. [PMID: 35479315 PMCID: PMC9035522 DOI: 10.3389/fphar.2022.764930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 02/11/2022] [Indexed: 11/13/2022] Open
Abstract
Background: No effective medication is available for symptomatic bradyarrhythmia, particularly in low socioeconomic status (SES) population. Objective: To explore the safety and efficacy of Yuanjiang decoction, a traditional Chinese medicinal prescription, for symptomatic bradyarrhythmia on a compassionate-use basis. Methods: This compassionate-use study was conducted in Beijing, China between January 2019 and January 2020. Eligible participants were recruited and treated with Yuanjiang decoction (composed of 6 Chinese herbal medicines), 200 ml twice daily for 16 weeks. Analyses were done with the intention-to-treat (ITT) approach. The primary outcome measure was the proportion of participants who achieved a favorable treatment outcome at 16 weeks. Results: As of January 2020, 184 patients were included. After 16-weeks treatment, 12 participants were lost to contact while 21 participants were terminated from this study, with a drop-out rate of 17.93%. The most common treatment-related adverse events were xerostomia (6.52%), constipation (6.45%) and sleepiness (3.26%). The proportion of participants with favorable treatment outcome was 65.22% at 4 weeks, 59.78% at 8 weeks (OR: 1.11, 95% CI: 0.71–1.73), 61.41% at 12 weeks (OR: 1.16, 95% CI: 0.92–1.45) and 60.87% at 16 weeks (OR: 1.15, 95% CI: 0.98–1.35). In the multifactor regression analysis, the favorable treatment outcome at 16 weeks was significantly associated with completing at least 8 weeks treatment (OR: 2.053, 95% CI: 1.064–3.560), while unfavorable treatment outcome was significantly associated with an atrioventricular block (OR: 0.255, 95% CI: 0.083–0.784), current smoking (OR: 0.343, 95% CI: 0.027–0.487), and syncope in the month before treatment (OR: 0.321, 95%CI: 0.114–0.904). Conclusion: This compassionate-use study showed encouraging outcomes of treatment with Yuanjiang decoction, without serious adverse events. This study identified several key factors that may affect outcomes. These findings helped inform the design and assess the feasibility of a large-scale randomized clinical trial.
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Affiliation(s)
- Zhang Wan-Tong
- Institute of Clinical Pharmacology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Beijing, China
- NMPA Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, Beijing, China
| | - Zhu Bao-Chen
- Department of Pharmacy, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Liu Zhao
- Tobacco Medicine and Tobacco Cessation Center, China-Japan Friendship Hospital, Beijing, China
| | - Wang Xu-Jie
- Institute of Clinical Pharmacology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Beijing, China
- NMPA Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, Beijing, China
| | - Gao Rui
- Institute of Clinical Pharmacology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Beijing, China
- NMPA Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, Beijing, China
| | - Xiao Ning
- National Clinical Research Center for Chinese Medicine Cardiology, Beijing, China
| | - Tang Wei
- NMPA Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, Beijing, China
| | - Wu Yu-Fei
- NMPA Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, Beijing, China
| | - Phoebe Miles
- Faculty of Humanities and Social Sciences, University of Nottingham, Ningbo, China
| | - Weng Wei-Liang
- Institute of Clinical Pharmacology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Beijing, China
- *Correspondence: Weng Wei-Liang, ; Li Qiu-Yan,
| | - Lin Hao-Xiang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Li Qiu-Yan
- National Clinical Research Center for Chinese Medicine Cardiology, Beijing, China
- NMPA Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, Beijing, China
- Stroke Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- *Correspondence: Weng Wei-Liang, ; Li Qiu-Yan,
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Cheang I, Liao S, Zhu Q, Ni G, Wei C, Jia Z, Wu Y, Li X. Integrating Evidence of the Traditional Chinese Medicine Collateral Disease Theory in Prevention and Treatment of Cardiovascular Continuum. Front Pharmacol 2022; 13:867521. [PMID: 35370696 PMCID: PMC8964948 DOI: 10.3389/fphar.2022.867521] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/23/2022] [Indexed: 11/13/2022] Open
Abstract
Cardiovascular disease has become a major public health problem. The concept of “cardiovascular continuum” refers to the continuous process from the risk factors that lead to arteriosclerosis, vulnerable plaque rupture, myocardial infarction, arrhythmia, heart failure, and death. These characteristics of etiology and progressive development coincide with the idea of “preventing disease” in traditional Chinese medicine (TCM), which corresponds to the process of systemic intervention. With the update of the understanding via translational medicine, this article reviews the current evidence of the TCM collateral disease theory set prescriptions in both mechanical and clinical aspects, which could lead to the development of new therapeutic strategies for prevention and treatment.
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Affiliation(s)
- Iokfai Cheang
- Department of Cardiology, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
| | - Shengen Liao
- Department of Cardiology, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
| | - Qingqing Zhu
- Department of Cardiology, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
| | - Gehui Ni
- Department of Cardiology, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
| | - Cong Wei
- National Key Laboratory of Collateral Disease Research and Innovative Chinese Medicine, Shijiazhuang, China.,Hebei Yiling Hospital, Key Disciplines of State Administration of TCM for Collateral Disease, Shijiazhuang, China
| | - Zhenhua Jia
- National Key Laboratory of Collateral Disease Research and Innovative Chinese Medicine, Shijiazhuang, China.,Hebei Yiling Hospital, Key Disciplines of State Administration of TCM for Collateral Disease, Shijiazhuang, China
| | - Yiling Wu
- National Key Laboratory of Collateral Disease Research and Innovative Chinese Medicine, Shijiazhuang, China.,Hebei Yiling Hospital, Key Disciplines of State Administration of TCM for Collateral Disease, Shijiazhuang, China
| | - Xinli Li
- Department of Cardiology, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
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Efficacy and Safety of Chinese Medicine in Treating Arrhythmia: Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:9960471. [PMID: 34745310 PMCID: PMC8570860 DOI: 10.1155/2021/9960471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 09/12/2021] [Accepted: 09/13/2021] [Indexed: 11/29/2022]
Abstract
Objective To evaluate the clinical efficacy of traditional Chinese medicine in the treatment of arrhythmia. Methods The researchers searched CNKI, VIP, WF, PubMed, Web of Science, and Cochrane Library with the set-up themes as randomized controlled trials (RCTs) on the clinical efficacy of traditional Chinese medicine in the treatment of arrhythmia. This research evaluated all the retrieve literature and conducted selection based on the evaluation. Stata software was applied for meta-analysis. Results 23 articles were retrieved with a total patient number of 2846. The results observed from the meta-analysis indicated the following: (1) compared with the result showed in placebo group, the traditional Chinese medicine group presented to have good efficacy, especially in the treatment of premature ventricular contractions. (2) In comparison with the western medicine group, the curative effect of Chinese medicine could approximately equal the therapeutic effect as western medicine. (3) Compared with the application of sole western medicine group, the combination of both traditional Chinese medicine and western medicine could have a better curative effect. Conclusion In the treatment of arrhythmia disease, the application of traditional Chinese medicine can be considered as an effective method. In addition to that, the therapeutic effect obtained from the combination of both Chinese traditional medicine and western medicine is clinically better than that of the sole use of western medicine.
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Wang T, Streeter H, Wang X, Purnama U, Lyu M, Carr C, Ma YL. A Network Pharmacology Study of the Multi-Targeting Profile of an Antiarrhythmic Chinese Medicine Xin Su Ning. Front Pharmacol 2019; 10:1138. [PMID: 31607935 PMCID: PMC6774044 DOI: 10.3389/fphar.2019.01138] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 09/04/2019] [Indexed: 12/31/2022] Open
Abstract
Xin Su Ning (XSN) is a China patented and certified traditional Chinese herbal medicine used to treat premature ventricular contractions (PVCs) since 2005. XSN is formulated with 11 herbs, designed to treat arrhythmia with phlegm-heat heart-disturbed syndrome (PHHD) according to Chinese medicine theory. The rational compatibility of the 11 herbs decides the therapeutic outcome of XSN. Due to the multicomponent nature of traditional Chinese medicine, it is difficult to use conventional pharmacology to interpret the therapeutic mechanism of XSN in terms of clear-cut drug molecule and target interactions. Network pharmacology/systematic pharmacology usually consider all the components in a formula with the same weight; therefore, the proportion of the weight of the components has been ignored. In the present study, we introduced a novel coefficient to mimic the relative amount of all the components in relation with the weight of the corresponding herb in the formula. The coefficient is also used to weigh the pharmacological effect of XSN on all relative biological pathways. We also used the cellular electrophysiological data generated in our lab, such as the effect of liensinine and isoliquiritigenin on NaV1.5 channels; we therefore set sodium channel as one of the targets of these two components, which would support the clinical efficacy of XSN in treating tachyarrhythmia. Combining the collected data and our discovery, a panoramagram of the pharmacological mechanism of XSN was established. Pathway enrichment and analysis showed that XSN treated PHHD arrhythmia through multiple ion channels regulation, protecting the heart from I/R injury, inhibiting the apoptosis of cardiomyocyte, and improving glucose and lipid metabolism.
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Affiliation(s)
- Taiyi Wang
- Oxford Chinese Medicine Research Centre, University of Oxford, Oxford, United Kingdom.,Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom
| | - Hamish Streeter
- Oxford Chinese Medicine Research Centre, University of Oxford, Oxford, United Kingdom.,Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom
| | - Xuan Wang
- Oxford Chinese Medicine Research Centre, University of Oxford, Oxford, United Kingdom.,Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom
| | - Ujang Purnama
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom
| | - Ming Lyu
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Carolyn Carr
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom
| | - Yu-Ling Ma
- Oxford Chinese Medicine Research Centre, University of Oxford, Oxford, United Kingdom.,Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom
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Zhang W, Huai Y, Miao Z, Qian A, Wang Y. Systems Pharmacology for Investigation of the Mechanisms of Action of Traditional Chinese Medicine in Drug Discovery. Front Pharmacol 2019; 10:743. [PMID: 31379563 PMCID: PMC6657703 DOI: 10.3389/fphar.2019.00743] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 06/07/2019] [Indexed: 01/01/2023] Open
Abstract
As a traditional medical intervention in Asia and a complementary and alternative medicine in western countries, traditional Chinese medicine (TCM) has attracted global attention in the life science field. TCM provides extensive natural resources for medicinal compounds, and these resources are generally regarded as effective and safe for use in drug discovery. However, owing to the complexity of compounds and their related multiple targets of TCM, it remains difficult to dissect the mechanisms of action of herbal medicines at a holistic level. To solve the issue, in the review, we proposed a novel approach of systems pharmacology to identify the bioactive compounds, predict their related targets, and illustrate the molecular mechanisms of action of TCM. With a predominant focus on the mechanisms of actions of TCM, we also highlighted the application of the systems pharmacology approach for the prediction of drug combination and dynamic analysis, the synergistic effects of TCMs, formula dissection, and theory analysis. In summary, the systems pharmacology method contributes to understand the complex interactions among biological systems, drugs, and complex diseases from a network perspective. Consequently, systems pharmacology provides a novel approach to promote drug discovery in a precise manner and a systems level, thus facilitating the modernization of TCM.
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Affiliation(s)
- Wenjuan Zhang
- Lab for Bone Metabolism, Key Lab for Space Biosciences and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi’an, China
- Research Center for Special Medicine and Health Systems Engineering, School of Life Sciences, Northwestern Polytechnical University, Xi’an, China
- NPU-UAB Joint Laboratory for Bone Metabolism, School of Life Sciences, Northwestern Polytechnical University, Xi’an, China
| | - Ying Huai
- Lab for Bone Metabolism, Key Lab for Space Biosciences and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi’an, China
- Research Center for Special Medicine and Health Systems Engineering, School of Life Sciences, Northwestern Polytechnical University, Xi’an, China
- NPU-UAB Joint Laboratory for Bone Metabolism, School of Life Sciences, Northwestern Polytechnical University, Xi’an, China
| | - Zhiping Miao
- Lab for Bone Metabolism, Key Lab for Space Biosciences and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi’an, China
- Research Center for Special Medicine and Health Systems Engineering, School of Life Sciences, Northwestern Polytechnical University, Xi’an, China
- NPU-UAB Joint Laboratory for Bone Metabolism, School of Life Sciences, Northwestern Polytechnical University, Xi’an, China
| | - Airong Qian
- Lab for Bone Metabolism, Key Lab for Space Biosciences and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi’an, China
- Research Center for Special Medicine and Health Systems Engineering, School of Life Sciences, Northwestern Polytechnical University, Xi’an, China
- NPU-UAB Joint Laboratory for Bone Metabolism, School of Life Sciences, Northwestern Polytechnical University, Xi’an, China
| | - Yonghua Wang
- Lab of Systems Pharmacology, College of Life Sciences, Northwest University, Xi’an, China
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Acute Efficacy of a Traditional Chinese Medicine for Treatment of Frequent Premature Ventricular Contractions in Patients with Concomitant Sinus Bradycardia: Results from a Double-Blind, Placebo-Controlled, Multicentre, Randomized Clinical Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:3917282. [PMID: 30949218 PMCID: PMC6425419 DOI: 10.1155/2019/3917282] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 02/15/2019] [Indexed: 11/18/2022]
Abstract
Pharmacological antiarrhythmic therapy such as beta-blockers in patients with frequent premature ventricular contractions (PVCs) and concomitant bradycardia is challenging. A traditional Chinese medicine, Shensong Yangxin (SSYX), has been effective in treatment of frequent PVCs and sinus bradycardia (SB) in separate patient cohorts. This double-blind, placebo-controlled, multicentre, randomized clinical trial investigates the acute efficacy of SSYX in reducing PVCs burden in patients with concomitant SB. Patients with symptomatic, frequent PVCs, and SB, defined as mean heart rate (MHR) of 45 to 59 beats per min (bpm), were recruited at 33 medical centres in mainland China and randomly assigned by computer to either SSYX or matching placebo for eight weeks. Patients, investigators, and trial personnel were masked to treatment allocation. Primary endpoints were changes in PVCs burden and MHR as assessed by 24-hour Holter monitoring relative to baseline. Secondary efficacy endpoints were subjective symptom score, ECG, and biochemical parameters. Analysis was based on intention-to-treat principles. 333 patients were randomized, of which 166 received SSYX and 167 placebo. Baseline characteristics did not differ. SSYX reduced PVCs burden by 68.2% (p < 0.001) and increased MHR by 10.9% (p < 0.001) compared to 32.2% and 4.7%, respectively, in the placebo group. SSYX group experienced greater symptomatic improvement (p < 0.001). No differences in reported adverse events were seen (20 versus 23). SSYX is an effective antiarrhythmic therapy for symptomatic, frequent PVCs uniquely suited patients with concomitant SB. Clinical trial number was NCT01750775.
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Jiang C, Wang X, Dang S, Wang X, Deng Q, Hu J, Huang CX. Chinese Medicine Shensong Yangxin Capsule () Ameliorates Myocardial Microcirculation Dysfunction in Rabbits with Chronic Myocardial Infarction. Chin J Integr Med 2019; 27:24-30. [PMID: 30656600 DOI: 10.1007/s11655-018-2578-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the effect of Chinese compound Shensong Yangxin Capsule ( , SSYX) on myocardial microcirculation in myocardial-infarcted rabbits. METHODS Myocardial infarction (MI) was established in rabbits by ligation of the left circumflex coronary. Thirty rabbits were randomly divided into the control group, the MI group (model), and the MI treated with SSYX group (MI+SSYX) by a random number table method. After 4 weeks of administration, low-energy real-time myocardial contrast echocardiography (RT-MCE) was conducted to assess the microcirculatory perfusion. Immunofluorescence double staining was used to detect the capillary density. The endothelial ultrastructure was observed with a transmission electron microscope. The mRNA expression levels of vascular endothelial growth factor (VEGF), endothelin 1 (ET-1), prostaglandin I2 (PGI2) and endothelial nitric oxide synthase (eNOS) were measured by real-time quantitative polymerase chain reaction (Real-time PCR). The plasmic levels of ET-1, thromboxane A2 (TXA2), nitric oxide (NO) and von willebrand factor (vWF) were examined with enzyme-linked immunosorbent assays (ELISA). RESULTS SSYX significantly improved the myocardial blood volume, myocardial micro bubble velocity, and myocardial inflow according to the examination of RT-MCE, and it visibly ameliorated the capillary endothelial structure. Furthermore, compared with the MI group, the plasma levels of TXA2, ET-1 and vWF contents significantly decreased in the MI+SSYX group, and the ET-1 mRNA expression levels of myocardium in the border zone significantly decreased, and the VEGF, PGI2 and eNOS mRNA expression levels significantly increased (all P<0.05). CONCLUSIONS SSYX has favorable advantages in ameliorating the impaired myocardial microcirculation following MI. The mechanisms of the effect are related to the ability of SSYX in balancing the endothelial-derived vasodilators and vasoconstrictors, and up-regulating the expression of VEGF and eNOS.
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Affiliation(s)
- Chan Jiang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430061, China
- Cardiovascular Research Institute of Wuhan University, Wuhan, 430061, China
| | - Xi Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430061, China.
- Cardiovascular Research Institute of Wuhan University, Wuhan, 430061, China.
| | - Song Dang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430061, China
- Cardiovascular Research Institute of Wuhan University, Wuhan, 430061, China
| | - Xin Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430061, China
- Cardiovascular Research Institute of Wuhan University, Wuhan, 430061, China
| | - Qing Deng
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430061, China
- Cardiovascular Research Institute of Wuhan University, Wuhan, 430061, China
| | - Juan Hu
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430061, China
- Cardiovascular Research Institute of Wuhan University, Wuhan, 430061, China
| | - Cong-Xin Huang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430061, China
- Cardiovascular Research Institute of Wuhan University, Wuhan, 430061, China
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Liu S, Tian G, Chen J, Zhang X, Wu A, Li M, Sun Y, Liu B, Xing Y, Shang H. Traditional Chinese Medicine for Bradyarrhythmia: Evidence and Potential Mechanisms. Front Pharmacol 2018; 9:324. [PMID: 29686614 PMCID: PMC5900793 DOI: 10.3389/fphar.2018.00324] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 03/20/2018] [Indexed: 02/05/2023] Open
Abstract
Importance: The incidence of Bradyarrhythmias is high among the population. However, at early stages of the disease, it cannot always get enough attention and is lack of safe and effective therapies, until it is serious enough to resort to pacemaker implantation. Traditional Chinese Medicine (TCM) has a long history of treating Bradyarrhythmia, with a lot of formulas being widely used in clinical practice. While the effectiveness and the underlying mechanisms of these formulas have not yet been clearly identified. Objective: To evaluate the effectiveness of some common TCM formulas in treating patients with Bradyarrhythmia and to summarize the current evidence as to their mechanisms. Data Sources: Relevant studies were identified by searching for papers published from January 2000 to August 2017 in Pubmed; EMBASE; the Cochrane Library (Cochrane Central Register of Controlled Trials); the China National Knowledge Internet; and the China biology medicine, Wanfang, and VIP databases. The following medical subject heading (MeSH) terms were included for Pubmed search and adapted for other databases as needed-“Medicine, Chinese Traditional,” “Bradycardia.” Study Selection: Randomized clinical trials investigating treatment outcomes in Bradyarrhythmia patients with one of the six TCM formulas (Shenxian-shengmai oral liquid, Shensong Yangxin capsule, XinBao pill, Mahuang-Fuzi-Xixin decoction, Zhigancao decoction and Shengmai injection). Data Extraction and Synthesis: Two independent reviewers performed the data extraction and assessed study quality. A meta-analysis was performed to calculate risk ratio (RR) and 95% confidence index (CI) using random-effects and fixed-effects model. Results: A total of 121 clinical trials with 11138 patients were included. Of the six TCM formulas, SXSM (RR:1.33, 95% CI 1.27 to 1.39, P < 0.00001), SSYX (RR:1.52, 95% CI 1.40 to 1.66, P < 0.00001), XB can be more effective than common treatment (RR 1.18, 95% CI 1.11 to 1.26, P < 0.00001), as well as placebo (RR 5.33, 95% CI 2.88-9.87, P < 0.00001), but less effective than TCM dialectical therapy (RR:0.75, 95% CI 0.68 to 0.82, P < 0.00001). Compared to the control group, MFX (RR:1.30, 95%CI 1.23 to 1.37, P < 0.00001), ZGC (RR:1.35, 95%CI 1.23 to 1.48, P < 0.00001), SMI (RR:1.36, 95%CI 1.21 to 1.52, P < 0.00001) can be more effective. The overall quality of the included trials were relatively low, with the limitations of small sample size, inadequate descriptions in randomization, allocation concealment and blinding methods. Conclusions and Relevance: There are evidence that some TCM formulas might help to relieve Bradyarrhythmias. But with the relatively low quality of the clinical trials and mechanism studies, we still need more high-quality researches to verify the conclusions.
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Affiliation(s)
- Shuo Liu
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Guihua Tian
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China.,Chinese Cochrane Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Chen
- Baokang Hospital Affiliated to Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xiaoyu Zhang
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Aiming Wu
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Min Li
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Yang Sun
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Baoshan Liu
- Tianjin Medical University General Hospital, Tianjin, China
| | - Yanwei Xing
- Guang'anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Hongcai Shang
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
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The Role of Biologically Active Ingredients from Natural Drug Treatments for Arrhythmias in Different Mechanisms. BIOMED RESEARCH INTERNATIONAL 2017; 2017:4615727. [PMID: 28497050 PMCID: PMC5405360 DOI: 10.1155/2017/4615727] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Accepted: 02/09/2017] [Indexed: 12/13/2022]
Abstract
Arrhythmia is a disease that is caused by abnormal electrical activity in the heart rate or rhythm. It is the major cause of cardiovascular morbidity and mortality. Although several antiarrhythmic drugs have been used in clinic for decades, their application is often limited by their adverse effects. As a result, natural drugs, which have fewer side effects, are now being used to treat arrhythmias. We searched for all articles on the role of biologically active ingredients from natural drug treatments for arrhythmias in different mechanisms in PubMed. This study reviews 19 natural drug therapies, with 18 active ingredient therapies, such as alkaloids, flavonoids, saponins, quinones, and terpenes, and two kinds of traditional Chinese medicine compound (Wenxin-Keli and Shensongyangxin), all of which have been studied and reported as having antiarrhythmic effects. The primary focus is the proposed antiarrhythmic mechanism of each natural drug agent. Conclusion. We stress persistent vigilance on the part of the provider in discussing the use of natural drug agents to provide a solid theoretical foundation for further research on antiarrhythmia drugs.
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Zhao HY, Zhang SD, Zhang K, Wang X, Zhao QY, Zhang SJ, Dai ZX, Qian YS, Zhang YJ, Wei HT, Tang YH, Huang CX. Effect of Shensong Yangxin on the Progression of Paroxysmal Atrial Fibrillation is Correlated with Regulation of Autonomic Nerve Activity. Chin Med J (Engl) 2017; 130:171-178. [PMID: 28091409 PMCID: PMC5282674 DOI: 10.4103/0366-6999.197997] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Shensong Yangxin (SSYX), a traditional Chinese herbal medicine, has long been used clinically to treat arrhythmias in China. However, the mechanism of SSYX on atrial fibrillation (AF) is unknown. In this study, we tested the hypothesis that the effect of SSYX on the progression of paroxysmal AF is correlated with the regulation of autonomic nerve activity. METHODS Eighteen mongrel dogs were randomly divided into control group (n = 6), pacing group (n = 6), and pacing + SSYX group (n = 6). The control group was implanted with pacemakers without pacing; the pacing group was implanted with pacemakers with long-term intermittent atrial pacing; the pacing + SSYX group underwent long-term intermittent atrial pacing and SSYX oral administration. RESULTS Compared to the pacing group, the parameters of heart rate variability were lower after 8 weeks in the pacing + SSYX group (low-frequency [LF] component: 20.85 ± 3.14 vs. 15.3 ± 1.89 ms 2 , P = 0.004; LF component/high-frequency component: 1.34 ± 0.33 vs. 0.77 ± 0.15, P < 0.001). The atrial effective refractory period (AERP) was shorter and the dispersion of the AERP was higher after 8 weeks in the pacing group, while the changes were suppressed by SSYX intake. The dogs in the pacing group had more episodes and longer durations of AF than that in the pacing + SSYX group. SSYX markedly inhibited the increase in sympathetic nerves and upregulation of tumor necrosis factor-alpha and interleukin-6 expression in the pacing + SSYX group. Furthermore, SSYX suppressed the decrease of acetylcholine and α7 nicotinic acetylcholine receptor protein induced by long-term intermittent atrial pacing. CONCLUSIONS SSYX substantially prevents atrial electrical remodeling and the progression of AF. These effects of SSYX may have association with regulating the imbalance of autonomic nerve activity and the cholinergic anti-inflammatory pathway.
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Affiliation(s)
- Hong-Yi Zhao
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060; Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei 430060; Hubei Key Laboratory of Cardiology, Wuhan, Hubei 430060, China
| | - Shu-Di Zhang
- Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China
| | - Kai Zhang
- Department of Oncology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550000, China
| | - Xi Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060; Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei 430060; Hubei Key Laboratory of Cardiology, Wuhan, Hubei 430060, China
| | - Qing-Yan Zhao
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060; Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei 430060; Hubei Key Laboratory of Cardiology, Wuhan, Hubei 430060, China
| | - Shu-Juan Zhang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060; Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei 430060; Hubei Key Laboratory of Cardiology, Wuhan, Hubei 430060, China
| | - Zi-Xuan Dai
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060; Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei 430060; Hubei Key Laboratory of Cardiology, Wuhan, Hubei 430060, China
| | - Yong-Sheng Qian
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060; Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei 430060; Hubei Key Laboratory of Cardiology, Wuhan, Hubei 430060, China
| | - You-Jing Zhang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060; Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei 430060; Hubei Key Laboratory of Cardiology, Wuhan, Hubei 430060, China
| | - Hao-Tian Wei
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060; Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei 430060; Hubei Key Laboratory of Cardiology, Wuhan, Hubei 430060, China
| | - Yan-Hong Tang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060; Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei 430060; Hubei Key Laboratory of Cardiology, Wuhan, Hubei 430060, China
| | - Cong-Xin Huang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060; Cardiovascular Research Institute, Wuhan University, Wuhan, Hubei 430060; Hubei Key Laboratory of Cardiology, Wuhan, Hubei 430060, China
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Application of Traditional Chinese Medicine in Treatment of Atrial Fibrillation. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:1381732. [PMID: 28243308 PMCID: PMC5294366 DOI: 10.1155/2017/1381732] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 12/20/2016] [Accepted: 01/09/2017] [Indexed: 12/24/2022]
Abstract
Atrial fibrillation (AF) is the most common cardiac arrhythmia, which is related to many cardiac and cerebral vascular diseases, especially stroke. It can therefore increase cardiovascular mortality and all-cause death. The current treatments of AF remain to be western drugs and radiofrequency ablation which are limited by the tolerance of patients, adverse side effects, and high recurrence rate, especially for the elderly. On the contrary, traditional Chinese medicine (TCM) with long history of use involves various treatment methods, including Chinese herbal medicines (CHMs) or bioactive ingredients, Chinese patent medicines, acupuncture, Qigong, and Tai Chi Chuan. With more and more researches reported, the active roles of TCM in AF management have been discovered. Then it is likely that TCM would be effective preventive means and valuable additional remedy for AF. The potential mechanisms further found by numerous experimental studies showed the distinct characteristics of TCM. Some CHMs or bioactive ingredients are atrial-selective, while others are multichannel and multifunctional. Therefore, in this review we summarized the treatment strategies reported in TCM, with the purpose of providing novel ideas and directions for AF management.
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Shensong Yangxin (SSYX) ameliorates disordered excitation transmission by suppressing cardiac collagen hyperplasia in rabbits with chronic myocardial infarction. ACTA ACUST UNITED AC 2016; 36:162-167. [PMID: 27072956 DOI: 10.1007/s11596-016-1560-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 01/26/2016] [Indexed: 01/24/2023]
Abstract
The traditional Chinese medicine Shensong Yangxin (SSYX) can improve the clinical symptoms of arrhythmia in an integrated manner. This study aimed to investigate the electrophysiological effect of SSYX on the hearts of myocardial-infarcted rabbits and further explore the mechanism by which SSYX alleviates myocardial fibrosis. Myocardial infarction (MI) was established in rabbits by ligation of the left circumflex coronary. The rabbits were treated with SSYX (0.5 g/kg/d) or saline for 8 weeks by oral administration. Microelectrode array (MEA) technology was used in vivo for extracellular electrophysiological recordings of the infarct border zone. Masson's trichrome staining was used to observe myocardial fibrosis. Western blotting was performed to evaluate the protein expression levels of collagen I (COL I) and collagen III (COL III). Quantitative real-time polymerase chain reaction (real-time PCR) was performed to evaluate the TGF-β1 and MMP-2 mRNA expression levels. The results showed that the total activation time (TAT) and the dispersion of TAT were significantly increased and the excitation propagation markedly disordered after MI. SSYX could significantly decrease TAT and the dispersion of TAT, and significantly ameliorate the chaotic spread pattern of excitation. Furthermore, SSYX treatment could significantly decrease COL I and COL III protein levels and down-regulate TGF-β1 and MMP-2 mRNA expression levels in MI rabbits. It was concluded that SSYX may ameliorate cardiac electrophysiological abnormalities in infarcted hearts by decreasing the protein levels of COL I and COL III, down-regulating the mRNA expression levels of TGF-β1 and MMP2, and thereby reducing adverse cardiac remodeling.
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Identification of Proteins Implicated in the Increased Heart Rate in ShenSongYangXin-Treated Bradycardia Rabbits by iTRAQ-Based Quantitative Proteomics. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:385953. [PMID: 26770253 PMCID: PMC4685072 DOI: 10.1155/2015/385953] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 11/12/2015] [Indexed: 01/29/2023]
Abstract
The present study tries to identify proteins implicated in bradycardia rabbits in hearts after ShenSongYangXin (SSYX, a traditional Chinese medicine) treatment. Eighteen adult rabbits were randomly assigned to three groups: sham, model, and SSYX treatment groups. Heart rate was recorded in rabbits and proteins were isolated from ventricular muscle. We used isobaric tags for elative and absolute quantitation (iTRAQ) coupled with two-dimensional liquid chromatography-tandem mass spectrometry to identify altered proteins after SSYX treatment. The heart rate decreased after six weeks due to the injury of the sinoatrial node in the model group. This effect was partially reversed by 4-week SSYX treatment. A total of a2988 proteins were quantified by performing the iTRAQ-based experiments. Of these, 86 proteins were differentially expressed according to our criteria (42 upregulated and 44 downregulated). The identification of key proteins implicated in the treatment of bradycardia could serve as a foundation to better understand and further explore the molecular mechanism of SSYX treatment.
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Kanmanthareddy A, Reddy M, Ponnaganti G, Sanjani HP, Koripalli S, Adabala N, Buddam A, Janga P, Lakkireddy T, Bommana S, Vallakati A, Atkins D, Lakkireddy D. Alternative medicine in atrial fibrillation treatment-Yoga, acupuncture, biofeedback and more. J Thorac Dis 2015; 7:185-92. [PMID: 25713735 DOI: 10.3978/j.issn.2072-1439.2015.01.13] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 12/03/2014] [Indexed: 11/14/2022]
Abstract
The last decade has seen a significant improvement in the management of atrial fibrillation (AF) with the development of newer medications and improvement in catheter ablation techniques. Recurrence of AF remains a significant problem in these patients and medications offer limited supportive role. Complementary and alternative treatment strategies therefore remain a viable option for these AF patients. Several studies have shown improvement in AF symptoms with yoga therapy, acupuncture and biofeedback. There are also several herbal medicine and supplements such as omega-3 fatty acids, antioxidant vitamins, barberry, motherwort, cinchona, Shensongyangxin, hawthorn, Kella and Wenxin Keli that have been evaluated as potential therapeutic options in AF. These studies are however limited by small sample sizes with mixed results. Besides the pharmacological action, metabolism, interactions with other medications and the adverse effects of the herbal medications and supplements remain poorly understood. In spite of the above limitations, complementary therapies remain a promising option in the management of AF and further studies are necessary to validate their safety and efficacy.
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Affiliation(s)
- Arun Kanmanthareddy
- 1 School of Medicine, Creighton University, Omaha, Nebraska, USA ; 2 VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska, USA ; 3 The University of Kansas Medical Center and Hospital, Kansas City, Kansas, USA ; 4 Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio, USA
| | - Madhu Reddy
- 1 School of Medicine, Creighton University, Omaha, Nebraska, USA ; 2 VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska, USA ; 3 The University of Kansas Medical Center and Hospital, Kansas City, Kansas, USA ; 4 Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio, USA
| | - Gopi Ponnaganti
- 1 School of Medicine, Creighton University, Omaha, Nebraska, USA ; 2 VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska, USA ; 3 The University of Kansas Medical Center and Hospital, Kansas City, Kansas, USA ; 4 Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio, USA
| | - Hari Priya Sanjani
- 1 School of Medicine, Creighton University, Omaha, Nebraska, USA ; 2 VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska, USA ; 3 The University of Kansas Medical Center and Hospital, Kansas City, Kansas, USA ; 4 Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio, USA
| | - Sandeep Koripalli
- 1 School of Medicine, Creighton University, Omaha, Nebraska, USA ; 2 VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska, USA ; 3 The University of Kansas Medical Center and Hospital, Kansas City, Kansas, USA ; 4 Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio, USA
| | - Nivedita Adabala
- 1 School of Medicine, Creighton University, Omaha, Nebraska, USA ; 2 VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska, USA ; 3 The University of Kansas Medical Center and Hospital, Kansas City, Kansas, USA ; 4 Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio, USA
| | - Avanija Buddam
- 1 School of Medicine, Creighton University, Omaha, Nebraska, USA ; 2 VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska, USA ; 3 The University of Kansas Medical Center and Hospital, Kansas City, Kansas, USA ; 4 Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio, USA
| | - Pramod Janga
- 1 School of Medicine, Creighton University, Omaha, Nebraska, USA ; 2 VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska, USA ; 3 The University of Kansas Medical Center and Hospital, Kansas City, Kansas, USA ; 4 Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio, USA
| | - Thanmay Lakkireddy
- 1 School of Medicine, Creighton University, Omaha, Nebraska, USA ; 2 VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska, USA ; 3 The University of Kansas Medical Center and Hospital, Kansas City, Kansas, USA ; 4 Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio, USA
| | - Sudharani Bommana
- 1 School of Medicine, Creighton University, Omaha, Nebraska, USA ; 2 VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska, USA ; 3 The University of Kansas Medical Center and Hospital, Kansas City, Kansas, USA ; 4 Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio, USA
| | - Ajay Vallakati
- 1 School of Medicine, Creighton University, Omaha, Nebraska, USA ; 2 VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska, USA ; 3 The University of Kansas Medical Center and Hospital, Kansas City, Kansas, USA ; 4 Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio, USA
| | - Donita Atkins
- 1 School of Medicine, Creighton University, Omaha, Nebraska, USA ; 2 VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska, USA ; 3 The University of Kansas Medical Center and Hospital, Kansas City, Kansas, USA ; 4 Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio, USA
| | - Dhanunjaya Lakkireddy
- 1 School of Medicine, Creighton University, Omaha, Nebraska, USA ; 2 VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska, USA ; 3 The University of Kansas Medical Center and Hospital, Kansas City, Kansas, USA ; 4 Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio, USA
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Gene expression profile of increased heart rate in shensongyangxin-treated bradycardia rabbits. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:715937. [PMID: 25525447 PMCID: PMC4265696 DOI: 10.1155/2014/715937] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 10/22/2014] [Accepted: 11/03/2014] [Indexed: 11/29/2022]
Abstract
Aims. The present study tries to investigate the gene expression profile of bradycardia rabbits' hearts after SSYX (SSYX, a traditional Chinese medicine) treatment. Methods. Eighteen adult rabbits were randomly assigned in three groups: sham, model, and SSYX treatment groups. Heart rate was recorded in rabbits and total RNA was isolated from hearts. Gene expression profiling was conducted and quantitative real-time reverse transcription-polymerase chain reaction (RT-PCR) was performed to confirm the gene expression results. Patch clamp using human induced pluripotent stem cell-derived cardiomyocytes was applied to record the calcium current in the presence of SSYX. Results. The mean RR interval reduced after six weeks due to the injury of the sinoatrial node in the model group. This effect was partially reversed by 4-week SSYX treatment. cDNA microarray demonstrated that genes related with pacemaker current, calcium ion homeostasis, and signaling were altered by SSYX treatment. Results from patch clamp demonstrated that SSYX reduced the calcium current which is consistent with gene expression results. Conclusion. The present study shows mRNA remodeling of bradycardia and demonstrates that SSYX is effective in treating bradycardia by reversing altered gene expression in bradycardia models. Reduced calcium current by SSYX also confirmed the gene expression results.
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Shen N, Li X, Zhou T, Bilal MU, Du N, Hu Y, Qin W, Xie Y, Wang H, Wu J, Ju J, Fang Z, Wang L, Zhang Y. Shensong Yangxin Capsule prevents diabetic myocardial fibrosis by inhibiting TGF-β1/Smad signaling. JOURNAL OF ETHNOPHARMACOLOGY 2014; 157:161-170. [PMID: 25267579 DOI: 10.1016/j.jep.2014.09.035] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Revised: 07/29/2014] [Accepted: 09/15/2014] [Indexed: 06/03/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Shensong Yangxin Capsule (SSYX), a traditional Chinese herbal medicine, has long been used clinically to treat arrhythmias in China. However, the effect of SSYX on interstitial fibrosis in diabetic cardiomyopathy is unknown. The objective of this study was to investigate the effects of SSYX on myocardial fibrosis in diabetic rats. MATERIALS AND METHODS The antifibrotic effect of SSYX was investigated in streptozocin (STZ)-induced diabetic rats with high fat-diet (HFD). Fasting blood glucose, heart weight/body weight (HW/BW) ratio, total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) were measured. Echocardiography and histology examination were carried out to evaluate heart function. Expressions of Smad7, TGF-β1, collagen I (col-1), collagen III (col-3), MMP-2, MMP-9 and α-SMA mRNA in heart tissues were measured by real time polymerase chain reaction (PCR). TGF-β1, Smad2/3, p-Smad2/3 and Smad7 protein levels were measured by western blot analysis. Proliferation of cardiac fibroblast was detected via immunofluorescence. RESULTS SSYX markedly decreased HW/BW ratio and improved the impaired cardiac function of type-2 diabetes mellitus (T2DM) rats. Transmission electron microscopy (TEM), haematoxylin and eosin (HE) and Masson staining results showed that SSYX attenuated cardiac fibrosis and collagen deposition in T2DM rats. Moreover, mRNA levels of TGF-β1, col-1, col-3, MMP-2, MMP-9 and α-SMA were downregulated, whereas Smad7 expression was upregulated after treatment with SSYX in rats with cardiac fibrosis. Furthermore, SSYX decreased protein levels of TGF-β1 and p-Smad2/3, and increased Smad7 expression. CONCLUSION TGF-β1/Smad signaling is involved in the cardiac fibrosis in diabetic cardiomyopathy and SSYX inhibits fibrosis and improves cardiac function via suppressing this pathway. Therefore, SSYX might be considered as an alternative therapeutic remedy for diabetic cardiomyopathy.
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Affiliation(s)
- Nannan Shen
- Department of Pharmacology (State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), Harbin Medical University, Harbin 150081, China
| | - Xiaoguang Li
- Department of Pharmacology (State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), Harbin Medical University, Harbin 150081, China
| | - Tong Zhou
- Department of Pharmacology (State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), Harbin Medical University, Harbin 150081, China
| | - Muhammad U Bilal
- Department of Pharmacology (State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), Harbin Medical University, Harbin 150081, China
| | - Ning Du
- Department of Pharmacology (State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), Harbin Medical University, Harbin 150081, China
| | - Yingying Hu
- Department of Pharmacology (State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), Harbin Medical University, Harbin 150081, China
| | - Wei Qin
- Department of Pharmacology (State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), Harbin Medical University, Harbin 150081, China
| | - Yingming Xie
- Department of Endocrinology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Hongtao Wang
- Hebei Yiling Pharmaceutical Research Institute, Shijiazhuang 050035, China
| | - Jianwei Wu
- Department of Pharmacology (State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), Harbin Medical University, Harbin 150081, China
| | - Jiaming Ju
- Department of Pharmacology (State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), Harbin Medical University, Harbin 150081, China
| | - Zhiwei Fang
- Department of Pharmacology (State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), Harbin Medical University, Harbin 150081, China
| | - Lihong Wang
- Department of Endocrinology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China.
| | - Yong Zhang
- Department of Pharmacology (State-Province Key Laboratories of Biomedicine-Pharmaceutics of China, Key Laboratory of Cardiovascular Research, Ministry of Education), Harbin Medical University, Harbin 150081, China; Institute of Cardiovascular Research, Harbin Medical University, Harbin 150081, China.
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Abstract
Traditional Chinese medication (TCM) is increasingly used to treat cardiovascular disease (CVD) in China and some other Asian countries. However, therapeutic efficacy and adverse effects of TCM are difficult to evaluate because few large-scale, randomized controlled trials (RCTs) enrolling patients with CVD have been performed. In this Review, we critically examine the current evidence on the cardiovascular effects of TCM. We reviewed 68 RCTs that included a total of 16,171 patients. The methodological quality of the trials was generally low. Only three reports described adverse cardiovascular events specifically, although in most studies TCM was associated with significant improvements in surrogate end points for hypertension, coronary heart disease, cardiac arrhythmias, and heart failure. The risk of adverse effects was not increased compared with no intervention, placebo, or Western medications. However, whether TCM is effective in reducing the all-cause or cardiovascular mortality in patients with CVD remains unknown and must be tested in large-scale RCTs with adverse cardiovascular events as primary end points.
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Zhao CQ, Zhou Y, Ping J, Xu LM. Traditional Chinese medicine for treatment of liver diseases: progress, challenges and opportunities. JOURNAL OF INTEGRATIVE MEDICINE 2014; 12:401-8. [PMID: 25292339 PMCID: PMC7128864 DOI: 10.1016/s2095-4964(14)60039-x] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 05/15/2014] [Indexed: 02/07/2023]
Abstract
Traditional Chinese medicine (TCM) is commonly used in treating liver diseases worldwide, especially in China. The advantages of using TCM for treatment of liver diseases include: protecting hepatocytes, inhibiting hepatic inflammation and antifibrosis in the liver. In this article, we introduce TCM herbal preparations from the Chinese materia medica (such as Fuzheng Huayu) that are typically used for the treatment of liver diseases. Literature surrounding the mechanisms of TCM therapy for treatment of liver diseases is presented and discussed. We propose that side effects of herbal compounds are often under-appreciated, and that more care should be taken in the prescription of potentially hepatotoxic medicines. Further, to deepen the understanding of TCM mechanisms, new techniques and methodologies must be developed. Future studies will lead to the enhancement of clinical outcomes of TCM. As complementary and alternative therapies, TCMs will play an expanding role in the future of liver disease treatment.
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Affiliation(s)
- Chang-qing Zhao
- Department of Liver Cirrhosis, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Yang Zhou
- Department of Liver Cirrhosis, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Jian Ping
- Institute of Liver Diseases, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Lie-ming Xu
- Institute of Liver Diseases, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; E-mail:
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