The traditional Chinese medicines treat chronic heart failure and their main bioactive constituents and mechanisms

Acta Pharm Sin B. 2023 May;13(5):1919-1955. doi: 10.1016/j.apsb.2023.02.005. Epub 2023 Feb 11.

Abstract

Chronic heart failure (CHF) is a severe public health problem with increasing morbidity and mortality, any treatment targeting a single session is insufficient to tackle this. CHF is characterized by reduced cardiac output resulting from neurohumoral dysregulation and cardiac remodeling, which might be related to oxidative stress, inflammation, endoplasmic reticulum stress, apoptosis, autophagy, mitochondrial function, and angiogenesis. These molecular mechanisms interact with each other through crosstalk. Historically, Chinese medicinal herbs have been widely applied in the treatment of CHF, and therapeutic effects of Chinese medicinal herbs and their ingredients have been scientifically confirmed over the past decades. Traditional Chinese medicine (TCM) with multiple components can confront the different pathogenesis of CHF through multiple targets. This review analyzes commonly used TCM patent drugs and TCM decoctions that are applicable to different stages of CHF based on clinical trials. Diverse bioactive ingredients in Chinese medicinal herbs have been found to treat CHF via multiple molecular mechanisms. This review comprehensively covers the key works on the effects and underlying mechanisms of TCM, herbal ingredients and synergistic effects of constituent compatibility in treating CHF, providing additional ideas to address this threat.

Keywords: Cardiac remodeling; Chinese medicinal herbs; Chronic heart failure; Constituent compatibility; Multiple targets; Natural ingredients; Synergistic effects; Traditional Chinese medicine formula.

Publication types

  • Review