Traditional Chinese Medicine Interventions for Heart Failure Management

Traditional Chinese Medicine (TCM) offers a complementary approach to the management of heart failure through herbal formulas, patent medicines and injectables that are used alongside standard pharmacotherapy. Interventions such as Qiliqiangxin, Qishen Yiqi and Shenfu preparations aim to modulate myocardial remodelling, reduce inflammation, inhibit apoptosis and improve energy metabolism. Clinical outcomes reported include enhanced left ventricular ejection fraction, improved exercise tolerance, reduced hospitalisation rates and better quality of life. Mechanistic studies leveraging network pharmacology, molecular docking and in vivo models have begun to elucidate how bioactive constituents target pathways such as NF-κB, STAT3 and PPARγ. Despite promising results, the field faces challenges in standardising formulations, improving methodological rigour and validating long-term safety and efficacy in diverse patient populations.

Research from Nature Portfolio

A seminal animal study demonstrated that early administration of a multi-herb capsule attenuates adverse cardiac remodelling following experimentally induced myocardial infarction. Treated mice displayed preserved systolic function, reduced interstitial fibrosis and lower rates of cardiomyocyte apoptosis three weeks after injury. Mechanistic investigation revealed that the intervention up-regulates peroxisome proliferator-activated receptor-γ (PPARγ), a transcription factor implicated in metabolic regulation and anti-fibrotic signalling. Pharmacological blockade of PPARγ abolished the protective effects, confirming its central role. This work provides a clear molecular basis for further development of TCM formulations as adjunctive therapies in post-infarction heart failure.

Traditional Chinese Medicine Interventions for Heart Failure Management publication trend

The graph below shows the total number of articles in traditional chinese medicine interventions for heart failure management across all publications each year (not limited to Nature Index journals).

Technical terms

Heart failure: A clinical syndrome in which the heart is unable to pump sufficient blood to meet the body’s needs, leading to symptoms such as breathlessness, fatigue and fluid retention.

Apoptosis: Programmed cell death that, when excessive in cardiac tissue, contributes to myocardial injury and adverse remodelling.

Fibrosis: Excessive deposition of extracellular matrix in the myocardium, leading to stiffening of the heart muscle and impaired function.

TLR4/NF-κB signalling: An innate immune pathway whereby Toll-like receptor 4 activates the transcription factor NF-κB, promoting the expression of pro-inflammatory cytokines.

PPARγ: Peroxisome proliferator-activated receptor-γ, a nuclear receptor that regulates gene expression controlling lipid metabolism, inflammation and cellular differentiation.

Surface plasmon resonance: A biophysical technique used to measure real-time interactions between molecules, often employed to confirm binding affinities of drug candidates to their targets.

References

1. Mechanism of XiJiaQi in the treatment of chronic heart failure: Integrated analysis by pharmacoinformatics, molecular dynamics simulation, and SPR validation. Computers in Biology and Medicine (2023).
2. Potential traditional Chinese medicines with anti-inflammation in the prevention of heart failure following myocardial infarction. Chinese Medicine (2023).
3. Traditional Chinese Medication Qiliqiangxin attenuates cardiac remodeling after acute myocardial infarction in mice. Scientific Reports (2015).
4. Protective Effect of Qiliqiangxin Capsule on Energy Metabolism and Myocardial Mitochondria in Pressure Overload Heart Failure Rats. Evidence-based Complementary and Alternative Medicine (2013).
5. Randomized, Double‐Blinded, Multicenter, Placebo‐Controlled Trial of Shenfu Injection for Treatment of Patients with Chronic Heart Failure during the Acute Phase of Symptom Aggravation (Yang and Qi Deficiency Syndrome). Evidence-based Complementary and Alternative Medicine (2019).