Efficacy and safety of berberine for congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy

      Abstract

      This study was designed to assess the efficacy and safety of berberine for chronic congestive heart failure (CHF). One hundred fifty-six patients with CHF and >90 ventricular premature complexes (VPCs) and/or nonsustained ventricular tachycardia (VT) on 24-hour Holter monitoring were randomly divided into 2 groups. All patients were given conventional therapy for CHF, consisting of angiotensin-converting enzyme inhibitors, digoxin, diuretics, and nitrates. Patients in the treatment group (n = 79) were also given berberine 1.2 to 2.0 g/day. The remaining 77 patients were given placebo. Symptoms, a 6-minute walk test, left ventricular (LV) ejection fraction (EF), frequency and complexity of VPCs, and quality of life were assessed after 8 weeks of treatment and during a mean 24-month follow-up. After treatment with berberine, there was a significantly greater increase in LVEF, exercise capacity, improvement of the dyspnea–fatigue index, and a decrease of frequency and complexity of VPCs compared with the control group. There was a significant decrease in mortality in the berberine-treated patients during long-term follow-up (7 patients receiving treatment died vs 13 on placebo, p <0.02). Proarrhythmia was not observed, and there were no apparent side effects. Thus, berberine improved quality of life and decreased VPCs and mortality in patients with CHF.
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      References

        • Marin-Neto J.A.
        • Maciel B.C.
        • Secches A.L.
        • Gallo L.
        Cardiovascular effects of berberine in patients with severe congestive heart failure.
        Clin Cardiol. 1988; 11: 253-260
        • Liu J.C.
        • Chan P.
        • Chen Y.J.
        • Tomlinson B.
        • Hong S.F.
        • Cheng J.T.
        The antihypertensive effect of berberine derivative 6-protoberberine in spontaneously hypertensive rats.
        Pharmacology. 1999; 59: 283-289
        • Chun Y.T.
        • Yip T.T.
        • Lau K.L.
        • Kong Y.C.
        A biochemical study on the hypotensive effect of berberine in rats.
        Gen Pharmac. 1978; 10: 177-182
        • Wang Y.X.
        • Yao X.J.
        • Tan Y.H.
        Effects of berberine on delayed after-depolarizations in ventricular muscles in vitro and vivo.
        J Cardiovasc Pharmacol. 1994; 23: 716-722
        • Zeng X.H.
        • Li Y.Y.
        Clinical observations of the effect of berberine for congestive heart failure.
        US Chinese J Angiocardiomyopathy. 2001; 6: 308-311
        • Zeng X.H.
        • Li Y.Y.
        • Zeng X.J.
        Beneficial effects of berberine in ischemic heart failure.
        J Qianna Medical College Nationalities. 2000; 3: 132-134
        • Wong M.
        • Bruce S.
        • Joseph D.
        • Lively H.
        Estimating left ventricular ejection fraction from two dimension echocardiograms.
        Echocardiography. 1991; 8: 1-8
        • Zeng X.
        HPLC determination of berberine in plasma of patients with ischemic heart failure.
        Chromatographia. 1998; 48: 589-590
        • Feinstein A.R.
        • Fisher M.B.
        • Pigeon J.G.
        Changes in dyspnea-fatigue ratings as indicators of quality of life in the treatment of congestive heart failure.
        Am J Cardiol. 1989; 64: 50-55
        • Thomas S.
        • Cohn J.N.
        • Pimobendan Multicenter Research Group
        Assessment of patients’ outcome with the Minnesota Living with Heart Failure questionnaire.
        Am Heart J. 1992; 124: 1017-1024
        • Wang K.K.
        Mechanism of the aortic relaxation induced by low concentration of berberine.
        Planta Medica. 1998; 64: 756-757
        • Benfey B.G.
        Mini review. Function of myocardial alpha-adrenoreceptors.
        Life Sci. 1982; 31: 101-106
        • Greco R.J.
        Actions of new inotropic agents. The effects of berberine on vascular smooth muscle.
        IRCS Med Sci. 1983; 11: 570-575
        • Zeng X.J.
        • Zeng H.-X.
        Relationship between the clinical effects of berberine in severe congestive heart failure and its concentration in plasma studied by HPLC.
        Biomed Chromatogr. 1999; 13: 442-444
        • Birdsall T.C.
        • Kally G.S.
        Berberine. Potential of an alkaloid found in several medicinal plants.
        Altern Med Review. 1997; 2 (103): 94
        • Ko S.T.
        • Lim D.Y.
        Influence of berberine on the blood pressure of rabbits.
        Arch Pharmacol Res. 1980; 3: 23-30
      1. Chun YT, Yip TT, Lau KL, Kong YC, Sankawa U. A biochemical study on the hypotensive effect of berberine in rats. Gen Pharmacol 1979;10:177–182

        • Sun F.L.
        Chinese herbs for diabetic mellitus.
        Chinese Prescription Drug. 2002; 7: 86-89
        • Hua Z.
        • Wang X.L.
        Inhibitory effect of berberine on potassium channels in guinea pig ventricular myocytes.
        Yao Hsueh Hsueh Pao. 1994; 29: 576-580