Hawthorn Extract Randomized Blinded Chronic Heart Failure (HERB CHF) Trial

Abstract

Aims Hawthorn's efficacy when added to contemporary evidence‐based heart failure therapy is unknown. We aimed to determine whether hawthorn increases submaximal exercise capacity when added to standard medical therapy. Methods and results We performed a randomized, double‐blind, placebo‐controlled trial in 120 ambulatory patients aged ≥18 years with New York Heart Association (NYHA) class II‐III chronic heart failure. All patients received conventional medical therapy, as tolerated, and were randomized to either hawthorn 450 mg twice daily or placebo for 6 months. The primary outcome was change in 6 min walk distance at 6 months. Secondary outcomes included quality of life (QOL) measures, peak oxygen consumption, and anaerobic threshold during maximal treadmill exercise testing, NYHA classification, left ventricular ejection fraction (LVEF), neurohormones, and measures of oxidative stress and inflammation. There were no significant differences between groups in the change in 6 min walk distance (P = 0.61), or on measures of QOL, functional capacity, neurohormones, oxidative stress, or inflammation. A modest difference in LVEF favoured hawthorn (P = 0.04). There were significantly more adverse events reported in the hawthorn group (P = 0.02), although most were non‐cardiac. Conclusion Hawthorn provides no symptomatic or functional benefit when given with standard medical therapy to patients with heart failure. This trial is registered in http://ClinicalTrials.gov ID: NCT00343902.

Effect of intravenous l-carnitine in Chinese patients with chronic heart failure

“…These parameters are widely used to assess efficacy in heart failure trials. [20][21][22] Seven days of LC supplementation resulted in a significantly greater improvement in NYHA class (60.9 vs. 44.7%; P ¼ 0.012), 6-MWD (+61 vs. +46 m; P ¼ 0.0497) and combined improvement in NYHA class and 6-MWD (29 vs. 13%, P ¼ 0.002) in the LC group compared with placebo. Conversely, no significant difference in LVEF, NT-proBNP plasma levels, and incidence of cardiovascular events was observed between the two groups.…”

Vitexin attenuates acute doxorubicin cardiotoxicity in rats via the suppression of oxidative stress, inflammation and apoptosis and the activation of FOXO3a

“…Furthermore, FOXO3a is involved in resistance to oxidative stress and also linked to apoptotic processes by modulating the expression levels of proapoptotic and antiapoptotic proteins that regulate antioxidant enzyme levels, including mitochondrial antioxidant manganese superoxide dismutase (MnSOD) (11)(12)(13). Hawthorn, of the rosaceae plant family, is a traditional Chinese medicine that is used to promote digestion (14). It has been reported that the ketone compounds extracted from the Hawthorn leaves are able to regulate blood lipids, blood pressure, increase coronary flow and protect the ischemic myocardium (15)(16)(17).…”

Herbal Supplements or Herbs in Heart Disease

“…In Europe, both homeopathic and allopathic doctors used the herb for various heart and cardiovascular ailments from the late nineteenth through the early twentieth centuries -and with great clinical success since hawthorn had entered American clinical practice by 1896 (Cleland et al, 2007;Dalli et al, 2011;Holubarsch et al, 2008;Koch and Malek, 2011;Zick et al, 2009).…”

“…As a measure of its incredible popularity, it is an ingredient of 213 commercial European herbal formulas, mostly for the cardiovascular system such as Crataegus laevigata and Crataegus oxyacantha (Cleland et al, 2007;Dalli et al, 2011;Holubarsch et al, 2008;Koch and Malek, 2011;Zick et al, 2009).…”

“…Hawthorn is also considered a mildly calming herb to the nervous system -an appropriate bonus considering that stress and nervousness often accompany cardiovascular problems (Cleland et al, 2007;Dalli et al, 2011;Holubarsch et al, 2008;Zick et al, 2009).…”