Table 1.
Application of single CHMs or bioactive ingredients in AF.
Original plant | Medicinal part | Bioactive ingredient | Methods of study | Result | Mechanism | Effect on the four principles of AF |
---|---|---|---|---|---|---|
Berberis vulgaris L. | Root | Berberine | Cellular study (rat and human atrial cells) | Vasodilation, positive ionotropic and negative chronotropic actions | Inhibition of Ito by binding to open state channels or shifting of the steady-state inactivation curve of Ito [7] | Rate and rhythm control management of primary disease and risk factors |
Root | Berberine | Animal study (rabbit) | Suppressing AF | Inhibiting Ito [7], prolonging ERP and APD [14] | Rhythm control | |
Root | Berberine | Cellular study (guinea pig cardiac myocytes) | Multichannel ion blocker | Inhibiting KATP [15], IKV [16], IKCa [16], IK1, and IK [17] | / | |
| ||||||
Saussurea involucrata (Kar. & Kir.) Sch. Bip. | Flower [19, 21], root [20] | Sesquiterpene lactone fraction [20] | Animal study (rat) | Anti-inflammatory and analgesic effects [19–21] | Stabilization of lysosomal membranes and an antiproliferative effect [20], preventing accumulation of inflammatory cells [21] | Management of risk factors |
Flower | Acacetin | Animal study (dog) | Suppressing AF | Inhibition of Kach, Kur, and Ito as an atrial-selective agent, prolonging APD and ERP without prolonging the corrected QT interval [8] | Rhythm control | |
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Crataegus rhipidophylla Gand. | Flower heads | Catechin and epicatechin | Cellular study | Antiplatelet aggregation | Inhibiting the biosynthesis of thromboxane A2 [12] | Antithrombotic therapy |
Fruit | Extract (containing flavonoid and procyanidin) | Cellular study (guinea pig ventricular myocytes) | Antiventricular arrhythmia | Prolonging the APD through blocking the delayed (IK) and inward (IK1) rectifier potassium currents [22] | / | |
Fruit | LI 132 (Faros® 300, CRA) [26], WS 1442 [24, 25] | Animal study (Wistar rats heart) [23] and isolated hearts (guinea pig) [26], clinical research [24, 25] | Positive ionotropic action, improving exercise capacity and decreasing mortality in heart failure patients [23–26] | Increasing Ca (2+)-concentration intracellularly [23], increasing cardiac contractility with prolongation of the effective refractory period [26] | Management of primary disease | |
Fruit | Epicatechin, hyperoside, and fluid extract | Cellular study (DPPH and ABTS techniques) | Antioxidant activity [29, 30] | / | Management of risk factors | |
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Corydalis turtschaninovii Besser | Tuber | Rotundium | Clinical research (AF patients) | Suppressing AF | Prolonging the ERP of atrial and atrioventricular node [33] | Rhythm control |
Tuber | D-Corydaline, d-glaucine, protopine, and l-tetrahydrocolumbamine | Animal study (rat) | Antiplatelet aggregation [34] | / | Antithrombotic therapy | |
Tuber | Pseudocoptisine | Cellular study (RAW 264.7 murine macrophage cells) | Anti-inflammatory | Reducing levels of iNOS, COX-2, necrosis factor-alpha (TNF-alpha), and IL-6 through the inhibition of nuclear factor kappa B (NF-kappaB) activation via the suppression of ERK and p38 phosphorylation [9] | Management of risk factors | |
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Leonurus cardiaca L. | Aerial parts | Primary and refined extracts | Cellular and organ studies (rabbit, rat, and guinea pig) | Decreasing the blood pressure, heart rate and increasing coronary blood flow and treating ventricular or sinus tachyarrhythmias [37] | Inhibiting the inward calcium (ICaL) and potassium (IKr) channels, lengthening Q-T, P-Q intervals and the activation time constant of I (f) in pacemaker cells [37, 38] | Rate control and management of risk factors |
Aerial parts | / | Clinical research | Fibrinolysis effect and antiplatelet aggregation | Decreasing blood viscosity, fibrinogen volume and increasing the deformability of Rbc [39] | Antithrombotic therapy | |
Aerial parts | Rutin and derivatives of hydroxycinnamic acid | Cellular study | Antioxidant activity [10, 11, 29, 30, 40] | / | Management of risk factors |