Traditional Chinese medicine on treating dilated cardiomyopathy

Tan, Yuqing; Chen, Heng-Wen; Li, Jun; Wu, Qing-Juan; Wu, Xiaoqing; Zhao, Wei

doi:10.1097/md.0000000000020777

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…Astragalus membranaceus can enhance cardiac function by increasing the ejection fraction, reducing the left ventricular end-diastolic diameter, extending walking distances, alleviating heart rate, and decreasing BNP levels. [22][23][24] Polygonatum sibiricum exhibits antiinflammatory, antioxidant, and anti-apoptotic effects. 25 Salvia miltiorrhiza can ameliorate myocardial remodeling potentially through the inhibition of angiotensin I receptors (AT1) and the blockade of the TGF-β/Smads signaling pathway.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Kuoxin Formula in the Treatment of Dilated Cardiomyopathy-Related Heart Failure: Study Protocol of a Randomized, Double-Blind, Placebo-Controlled, Multi-Center Clinical Trial

Wu,

An,

Lee

et al. 2024

IJGM

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Background: Dilated cardiomyopathy (DCM) is a severe heterogeneous cardiomyopathy characterized by cardiac enlargement and declining heart function, often leading to refractory heart failure and life-threatening outcomes, particularly prevalent in China. The challenge lies in the scarcity of targeted therapies with substantial efficacy for DCM. Additionally, traditional anti-heart failure drugs are constrained due to hypotension propensity or limited symptom improvement. Kuoxin Formula (KXF), internally endorsed at Longhua Hospital, demonstrates clear biological evidence for enhancing cardiac function and myocardial remodeling. Previous clinical studies suggest its potential to enhance patients' quality of life. This trial aims to further evaluate KXF's safety and efficacy in managing DCM-related heart failure. Methods: This prospective, randomized, double-blind, placebo-controlled, multicenter trial aims to recruit 230 DCM patients from five centers. Participants will be randomly assigned to either KXF or placebo for 12 weeks, with careful monitoring of key indicators and adverse events. The primary outcome measures the proportion of patients with NT-proBNP reduction exceeding 30%. Secondary outcomes include New York Heart Association functional classification, Traditional Chinese Medicine syndrome scores, 6-minute walk test, Lee's heart failure score, and Minnesota Heart Failure Quality of Life Scale score. Ventricular remodeling will be assessed using cardiac ultrasound and ELISA. Safety metrics and adverse events will be meticulously recorded. Discussion: This study will be the first multicentered research conducted in China that utilizes a randomized, double-blind, placebocontrolled design to investigate the use of TCM in the treatment of DCM. It seeks to develop new theoretical frameworks and provide solid clinical data to support the integration of TCM and modern medicine in treating heart failure in DCM patients. Trial Registration: China Clinical Trial Registry, ChiCTR2300068937. Registered on March 1, 2023. https://www.chictr.org.cn/bin/ project/edit?pid=190926.

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Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Kuoxin Formula in the Treatment of Dilated Cardiomyopathy-Related Heart Failure: Study Protocol of a Randomized, Double-Blind, Placebo-Controlled, Multi-Center Clinical Trial

Wu,

An,

Lee

et al. 2024

IJGM

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“…The etiology, pathogenesis, syndrome differentiation, and treatment of DCM-related diseases have been recorded in ancient Chinese medical literature, and good clinical efficacy has been achieved [ 59 , 60 ]. At present, TCM treatment of DCM is a new research and development direction with considerable advantages for treating and improving symptoms and the prognosis of patients with DCM [ 61 ].…”

Section: Discussionmentioning

confidence: 99%

Immune Mechanism, Gene Module, and Molecular Subtype Identification of Astragalus Membranaceus in the Treatment of Dilated Cardiomyopathy: An Integrated Bioinformatics Study

Chen

Han

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Astragalus membranaceus has complex components as a natural drug and has multilevel, multitarget, and multichannel effects on dilated cardiomyopathy (DCM). However, the immune mechanism, gene module, and molecular subtype of astragalus membranaceus in the treatment of DCM are still not revealed. Microarray information of GSE84796 was downloaded from the GEO database, including RNA sequencing data of seven normal cardiac tissues and ten DCM cardiac tissues. A total of 4029 DCM differentially expressed genes were obtained, including 1855 upregulated genes and 2174 downregulated genes. GO/KEGG/GSEA analysis suggested that the activation of T cells and B cells was the primary cause of DCM. WGCNA was used to obtain blue module genes. The blue module genes are primarily ADCY7, BANK1, CD1E, CD19, CD38, CD300LF, CLEC4E, FLT3, GPR18, HCAR3, IRF4, LAMP3, MRC1, SYK, and TLR8, which successfully divided DCM into three molecular subtypes. Based on the CIBERSORT algorithm, the immune infiltration profile of DCM was analyzed. Many immune cell subtypes, including the abovementioned immune cells, showed different levels of increased infiltration in the myocardial tissue of DCM. However, this infiltration pattern was not obviously correlated with clinical characteristics, such as age, EF, and sex. Based on network pharmacology and ClueGO, 20 active components of Astragalus membranaceus and 40 components of DMCTGS were obtained from TCMSP. Through analysis of the immune regulatory network, we found that Astragalus membranaceus effectively regulates the activation of immune cells, such as B cells and T cells, cytokine secretion, and other processes and can intervene in DCM at multiple components, targets, and levels. The above mechanisms were verified by molecular docking results, which confirmed that AKT1, VEGFA, MMP9, and RELA are promising potential targets of DCM.

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“…walking distances, alleviating heart rate, and decreasing B-type natriuretic peptide (BNP) levels(24,25). In addition, the polysaccharide component of Astragalus membranaceus is a crucial therapeutic ingredient, known to regulate apoptotic gene expression, inhibit myocardial cell apoptosis, reduce collagen synthesis, and alleviate myocardial brosis.…”

mentioning

confidence: 99%

Efficacy and safety of Kuoxin Formula in the treatment of dilated cardiomyopathy-related heart failure (Qi-Yin deficiency combined with blood stasis syndrome): study protocol of a randomized, double-blind, placebo-controlled, multi-center clinical trial

Wu,

An,

Lee

et al. 2024

Preprint

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Background Dilated cardiomyopathy (DCM) is a severe condition characterized by cardiac enlargement and declining heart function, often leading to refractory heart failure and life-threatening outcomes. Globally, and particularly in China, a notable challenge arises from the insufficient availability of targeted therapies demonstrating significant efficacy for DCM. Additionally, the application of traditional anti-heart failure drugs in DCM is constrained, as many patients exhibit a propensity for hypotension or show limited improvement in their heart failure symptoms. Kuoxin Formula (KXF), an internally agreed-upon prescription at Longhua Hospital, is supported by clear biological evidence for improving cardiac function and myocardial remodeling. Previous clinical studies have also demonstrated its potential to improve patients' quality of life. This trial aims to further evaluate the safety and efficacy of KXF in treating DCM -related heart failure. Method This prospective, randomized, double-blind, placebo-controlled, multicenter trial recruits 230 patients diagnosed with DCM (Qi-Yin deficiency combined with blood stasis syndrome) from five centers. Participants will be randomly assigned in a 1:1 ratio to either the KXF treatment group or a placebo group. The treatment will span 12 weeks, during which key indicators and adverse events will be monitored. The primary outcome is the proportion of patients whose NT-proBNP decreased by more than 30%. The secondary outcomes include the NYHA functional classification, TCM syndrome scores, echocardiographic parameters, TGF-β, PICP, CITP, galectin-3, ST2 levels, 6MWT, Lee's heart failure score, and MLHFQ score. Discussion: This study will be the first multicentered research conducted in China that utilizes a randomized, double-blind, placebo-controlled design to investigate the use of TCM in the treatment of dilated cardiomyopathy. It seeks to develop new theoretical frameworks and provide solid clinical data to support the integration of TCM and modern medicine in treating heart failure in DCM patients. Trial Registration: China Clinical Trial Registry, ChiCTR2300068937. Registered on March 1, 2023.

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Traditional Chinese medicine on treating dilated cardiomyopathy

Cited by 3 publications

References 18 publications

Efficacy and Safety of Kuoxin Formula in the Treatment of Dilated Cardiomyopathy-Related Heart Failure: Study Protocol of a Randomized, Double-Blind, Placebo-Controlled, Multi-Center Clinical Trial

Efficacy and Safety of Kuoxin Formula in the Treatment of Dilated Cardiomyopathy-Related Heart Failure: Study Protocol of a Randomized, Double-Blind, Placebo-Controlled, Multi-Center Clinical Trial

Immune Mechanism, Gene Module, and Molecular Subtype Identification of Astragalus Membranaceus in the Treatment of Dilated Cardiomyopathy: An Integrated Bioinformatics Study

Efficacy and safety of Kuoxin Formula in the treatment of dilated cardiomyopathy-related heart failure (Qi-Yin deficiency combined with blood stasis syndrome): study protocol of a randomized, double-blind, placebo-controlled, multi-center clinical trial

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