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Xing X, Guo J, Mo J, Li H, Zhang H, Shao B, Wang Y, Li H, Wang J, Leung CL, Jiang Y, Yin W, Chen H, He Q. Qili Qiangxin capsules for chronic heart failure: A GRADE-assessed clinical evidence and preclinical mechanism. Front Cardiovasc Med 2023; 9:1090616. [PMID: 36712277 PMCID: PMC9873992 DOI: 10.3389/fcvm.2022.1090616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 12/23/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction Chronic heart failure (CHF) has become an increasing concern with the aging of the population. This study aims to evaluate the effectiveness and safety of Qili Qiangxin capsules (QLQX) for CHF. Methods A systematic review and meta-analysis on clinical studies was conducted. The mechanisms of preclinical studies were summarized. Results We searched six electronic databases by 20 July 2022, and finally, 7 preclinical experiments (PEs) and 24 randomized controlled trials were included. The risk of bias was accessed by the SYRCLE and RoB 2.0 tool, respectively. PEs indicated that QLQX suppresses myocardial apoptosis, inhibits renin-angiotensin-aldosterone system activation, improves water retention, and enhances cardiocyte remodeling. In clinical studies, compared with routine treatment, QLQX could improve the indicators: clinical efficacy rate (RR = 1.16, 95% CI [1.12, 1.22], GRADE: moderate), left ventricular end-diastolic dimension (SMD = -1.04, 95% CI [-1.39, -0.70], GRADE: low), left ventricular ejection fraction (SMD = 1.20, 95% CI [0.97, 1.43], GRADE: moderate), 6-minute walk distance (SMD = 1.55, 95% CI [0.89, 2.21], GRADE: low), brain natriuretic peptide (SMD = -0.78, 95% CI [-1.06, -0.51], GRADE: low), N-terminal pro-brain natriuretic peptide (SMD = -2.15, 95% CI [-3.60, -0.71], GRADE: low), and adverse events (RR = 0.46, 95% CI [0.25, 0.87], GRADE: low). Discussion In summary, QLQX exerts a potential mechanism of utility on myocardial apoptosis and cardiac function and has noteworthy clinical adjuvant efficacy and safety in patients with CHF. Systematic review registration https://www.crd.york.ac.uk/prospero/.
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Affiliation(s)
- Xiaoxiao Xing
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jianbo Guo
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Juefei Mo
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Huashan Li
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hui Zhang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Baoyi Shao
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yifan Wang
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Haidi Li
- Inflammation and Immune Mediated Diseases Laboratory of Anhui, School of Pharmacy, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei, China
| | - Jianan Wang
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui, School of Pharmacy, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei, China
| | - Cheuk Lung Leung
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yun Jiang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Weixian Yin
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Haiyong Chen
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Chinese Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Qingyong He
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Chang X, Zhang W, Zhao Z, Ma C, Zhang T, Meng Q, Yan P, Zhang L, Zhao Y. Regulation of Mitochondrial Quality Control by Natural Drugs in the Treatment of Cardiovascular Diseases: Potential and Advantages. Front Cell Dev Biol 2020; 8:616139. [PMID: 33425924 PMCID: PMC7793684 DOI: 10.3389/fcell.2020.616139] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 11/18/2020] [Indexed: 12/13/2022] Open
Abstract
Mitochondria are double-membraned cellular organelles that provide the required energy and metabolic intermediates to cardiomyocytes. Mitochondrial respiratory chain defects, structure abnormalities, and DNA mutations can affect the normal function of cardiomyocytes, causing an imbalance in intracellular calcium ion homeostasis, production of reactive oxygen species, and apoptosis. Mitochondrial quality control (MQC) is an important process that maintains mitochondrial homeostasis in cardiomyocytes and involves multi-level regulatory mechanisms, such as mitophagy, mitochondrial fission and fusion, mitochondrial energy metabolism, mitochondrial antioxidant system, and mitochondrial respiratory chain. Furthermore, MQC plays a role in the pathological mechanisms of various cardiovascular diseases (CVDs). In recent years, the regulatory effects of natural plants, drugs, and active ingredients on MQC in the context of CVDs have received significant attention. Effective active ingredients in natural drugs can influence the production of energy-supplying substances in the mitochondria, interfere with the expression of genes associated with mitochondrial energy requirements, and regulate various mechanisms of MQC modulation. Thus, these ingredients have therapeutic effects against CVDs. This review provides useful information about novel treatment options for CVDs and development of novel drugs targeting MQC.
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Affiliation(s)
- Xing Chang
- China Academy of Chinese Medical Sciences, Beijing, China.,Guang'anmen Hospital of Chinese Academy of Traditional Chinese Medicine, Beijing, China
| | - Wenjin Zhang
- China Academy of Chinese Medical Sciences, Beijing, China.,College of Pharmacy, Ningxia Medical University, Yinchuan, China
| | - Zhenyu Zhao
- China Academy of Chinese Medical Sciences, Beijing, China
| | - Chunxia Ma
- Shandong Analysis and Test Center, Qilu University of Technology, Jinan, China
| | - Tian Zhang
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Qingyan Meng
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Peizheng Yan
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Lei Zhang
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Yuping Zhao
- China Academy of Chinese Medical Sciences, Beijing, China
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