Department of Cardiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, 310006 Hangzhou, Zhejiang, China.
Translational Medicine Research Center, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, 310006 Hangzhou, Zhejiang, China.
Rev Cardiovasc Med. 2022 Feb 12;23(2):60. doi: 10.31083/j.rcm2302060.
Heart failure (HF) is the end stage of several cardiovascular diseases with high mortality worldwide; however, current chemical drugs have not beneficial effect on reducing its mortality rate. Due to its properties of multiple targets components with multiple targets, natural products derived from traditional Chinese medicine (TCM) have exerts unique effects on the amelioration of the clinical symptoms of HF, yet, TCM is not widely used in the clinic since the potential therapeutic targets have not been fully investigated. Therefore, in this review, we briefly summarized the pathophysiological mechanism of HF and reviewed the published clinical evaluations of TCM and natural products from Chinese herbs to treat HF. Then, the therapeutic potential and the underlying mechanisms by which the natural products from Chinese herb exert their protective effects were further summarized. We concluded from this review that natural products from Chinese herbs have been shown to be more effective in treating HF by targeting multiple signaling pathways, including anticardiac hypertrophy, antifibrotic, anti-inflammatory, antioxidative and antiapoptotic activities. However, the major limitations of these compounds is that there are a lack of large scale, multicenter, randomized and controlled clinical trials for their use in treatment of HF, and the toxic effects of natural products from Chinese herbs also needed further investigation. Despite these limitations, further clinical trials and experimental studies will provide a better understanding of the mechanism of natural products from Chinese herbs and promote their wide use to treat HF.
心力衰竭(HF)是全球几种心血管疾病的终末期,死亡率很高;然而,目前的化学药物对降低其死亡率没有有益的作用。由于其具有多靶点成分的特性,来源于中药的天然产物对改善心力衰竭的临床症状有独特的作用,但由于潜在的治疗靶点尚未得到充分研究,中药在临床上并未广泛应用。因此,在这篇综述中,我们简要总结了心力衰竭的病理生理机制,并回顾了已发表的中药和草药天然产物治疗心力衰竭的临床评价。然后,进一步总结了天然产物通过靶向多个信号通路发挥保护作用的治疗潜力及其潜在机制。我们从这篇综述中得出结论,天然产物通过靶向多个信号通路,包括抗心肌肥厚、抗纤维化、抗炎、抗氧化和抗细胞凋亡作用,在治疗心力衰竭方面显示出更有效的作用。然而,这些化合物的主要局限性是缺乏大规模、多中心、随机对照临床试验来治疗心力衰竭,而且中药天然产物的毒性作用也需要进一步研究。尽管存在这些局限性,但进一步的临床试验和实验研究将提供对中药天然产物作用机制的更好理解,并促进其广泛用于治疗心力衰竭。