Table 6.

Natural products in reducing chemotherapy and radiotherapy-induced cardiotoxicity.

Name	Effect/Mechanism	Experimental setting/Model	Ingredients/Source	References
Sheng-Mai-San	Improvement of the syndrome of qi and yin deficiency, heart function and the quality of life of cancer patients	Patients	Made from Ginseng radis, Liriope spicata, and Schizandrae fructus Main chemical constituents: ginsenoside Rg, ginsenoside Re and schisandrin	Lo et al., 2012
Dan-Hong injection	Improvement of energy metabolism and reduction of oxidative stress	Doxorubicin-induced cardiotoxicity in H9c2 cells	Made from Radix Salviae miltiorrhizae and Flos Carthami tinctorii Main chemical constituents: catechol, tanshinone, salvianic aid A, Carthamin and carthamin yellow	Yi et al., 2018
San-Yang-Xue-Dai mixture	Inhibition of ROS-mediated p53 and MAPK signal pathways	Doxorubicin-induced cardiotoxicity in mice	Made from Daemonorops draco, Panax notoginseng, Scoparia dulcis, Aralia cordata, Alpinia ofcinarum, Dioscorea opposita, Wolfporia extensa,and Amomum villosum	Chen et al., 2018
Fermented C. sinensis	Inhibition of myocardial hypertrophy and myocardial damage, Improvement of systolic function, the antioxidant enzyme system, and cardiac energy metabolism, upregulation of the cAMP and AMPK signaling pathways	Doxorubicin-induced cardiotoxicity in rats	Protein, carbohydrate, fat, ash, cordycepin, H2O, amino acid, and adenosine	Wu et al., 2018
Diethyl blechnic	Anti-oxidation	Doxorubicin-induced apoptosis c and primary rat cardiomyocytes	A main compound isolated from S. miltiorrhiza	Yu et al., 2018a
Curcumin	Upregulation of 14-3-3γ expression	Doxorubicin-induced cardiotoxicity in mice and primary cardiomyocytes	Bioactive constituent of Curcuma longa L.	He et al., 2018
Saponin dioscin	Regulation of miR-140-5p-mediated myocardial oxidative stress	Doxorubicin-induced cardiotoxicity in H9c2 cells and rats	Found abundantly in legumes and yams	Zhao et al., 2018
Modified Zhi-Gan-Cao-Tang	Nourish heart yin and yang, anti-oxidation and inhibition of Na+/K+-ATPase	Anthracycline-induced congestive heart failure in an 18-year-old adolescent male	Radix Glycyrrhizae, Radix Ginseng, Fructus Jujubae, Radix Rehmanniae, Radix Ophiopogonis, Colla Corii Asini, Fructus Cannalis, Ramulus Cinnamomi, Rhizoma Zingiberis Recens, Carapax Trionycis, Plastrum Testudinis, Concha Ostreae, and Radix Paeoniae alba	Wu et al., 2015
P. grandiflorum	Anti-oxidation	Early breast cancer receiving anthracycline-based chemotherapy	Triterpenoid saponin, carbohydrates, and fibers	Hao et al., 2017
Flaxseed oil	Maintenance of the proper balance between pro-oxidant/antioxidant defense systems	Arsenic-induced cardiac toxicity in rats	Polyunsaturated fatty acid alpha-linolenic acid	Varghese et al., 2017
Parsley oil	Anti-oxidation and anti-inflammation and anti-apoptotic	Cisplatin-induced hepatic and cardiac injuries in rats	Phenolic compounds, particularly flavonoids (e.g., apigenin, apiin, and 600-acetylapiin), coumarins, furocoumarins, and essential oil components (mainly myristicin and apiol)	Abdellatief et al., 2017
Blueberry anthocyanins-enriched extracts	Anti-oxidation and anti-inflammation	Cyclophosphamide-induced cardiac injury in rats	3-glycosidic derivatives of cyanidin, delphinidin, malvidin, petunidin, and peonidin	Liu et al., 2015
R. cordifolia	Anti-oxidation	Cyclophosphamide-induced cardiac injury in rats	Alkaloids, flavonoids, saponins, and anthraquinones	Chandrashekar et al., 2018
Black grape juice	Anti-oxidation	Whole body γ-irradiation-induced heart toxicity of rats	Phenolics, flavonoids, tannin, gallic acid, catechin, resveratrol, caffeic acid, ellagic acid, quercetin, kaempferol	de Freitas et al., 2013
Sheng-Mai Zingerone	Decrease of caspase-3 gene expression and the prominent nuclear DNA fragmentation as well as increase of mitochondrial complexes' activities	Cisplatin- or γ-radiation-induced cardiotoxicity in rats	A active components of ginger	Soliman et al., 2018
Hesperidin	Inhibition of cellular damage and oxidative stress	γ-radiation-induced tissue damage in Sprague-Dawley rats	Isolated from the ordinary orange Citrus aurantium and other species of the genus Citrus	Pradeep et al., 2012