New idea of treatment of heart failure with traditional Chinese medical / 中国中药杂志

ABSTRACT

To discuss the potential role of medicinal herbs, especially those with effect of strengthening Qi, in the treatment of chronic heart failure (CHF) via modulating myocardial substrate metabolism. The relationships among heart failure, myocardial energetic metabolism and herbal medicine were analyzed in detail through reviewing and summarizing the accumulating knowledge and recent findings on myocardial metabolism, heart failure and herbal medicine. Either energy lack or abnormal energetic metabolism is one of the main causes to the initiation and development of heart failure. Recent studies suggest that the cardiac function in the patients with CHF could be improved by inhibiting the energy production from metabolism of fatty acid and enhancing the energy production from glucose metabolism. The concept of Qi in Chinese medicine is very close to the energy in western medicine. The decoction of Chinese medicine containing herbal medicine with effect of strengthening Qi and the herbal medicine themselves and their components were evidenced to be effective in improvement of heart failure and regulation of both lipid and glucose metabolism; more importantly, all these herbal medicine contain the multi-sugar which can be metabolized into single unit of sugar which may be metabolized as a substrate by myocardium and potentially produce the cardioprotective effect. Therefore, we may find out a novel way to explain why the herbal medicine with effect of strengthening Qi can improve cardiac function in patients with CHF. In other words, regulating myocardial metabolism is one of the mechanisms underlying the cardioprotection produced by herbal medicine with effect of strengthening Qi in the treatment of heart failure.