Mechanism-based targeting of cardiac arrhythmias by phytochemicals and medicinal herbs: A comprehensive review of preclinical and clinical evidence

Abstract

Cardiac arrhythmias, characterized by an irregular heartbeat, are associated with high mortality and morbidity. Because of the narrow therapeutic window of antiarrhythmic drugs (AADs), the management of arrhythmia is still challenging. Therefore, searching for new safe, and effective therapeutic options is unavoidable. In this study, the antiarrhythmic effects of medicinal plants and their active constituents were systematically reviewed to introduce some possible candidates for mechanism-based targeting of cardiac arrhythmias. PubMed, Embase, and Cochrane library were searched from inception to June 2021 to find the plant extracts, phytochemicals, and multi-component herbal preparations with antiarrhythmic activities. From 7337 identified results, 57 original studies consisting of 49 preclinical and eight clinical studies were finally included. Three plant extracts, eight multi-component herbal preparations, and 26 phytochemicals were found to have antiarrhythmic effects mostly mediated by affecting K+ channels, followed by modulating Ca2+ channels, upstream target pathways, Nav channels, gap junction channels, and autonomic receptors. The most investigated medicinal plants were Rhodiola crenulata and Vitis vinifera. Resveratrol, Oxymatrine, and Curcumin were the most studied phytochemicals found to have multiple mechanisms of antiarrhythmic action. This review emphasized the importance of research on the cardioprotective effect of medicinal plants and their bioactive compounds to guide the future development of new AADs. The most prevalent limitation of the studies was their unqualified methodology. Thus, future well-designed experimental and clinical studies are necessary to provide more reliable evidence.

Enhancing the Bioavailability and Bioactivity of Curcumin for Disease Prevention and Treatment

“…Free curcumin has been reported to have beneficial effects against several cardiac arrhythmias [ 143 , 144 , 145 , 146 ], attributed, among other actions, to its antioxidant properties [ 147 ]. It has also been demonstrated that an encapsulated lipopolymeric hybrid nanoparticle formulation of curcumin, while enhancing the bioavailability and stability of the compound, could protect against QT prolongation by activating the hERG (human ether-a-go-go-related gene) K+ channel, in a manner superior to liposomal curcumin [ 148 ].…”

Review on Cardiac Arrhythmias with ECG Interpretation on Different Myocardial Regions

“…So, the only area where the current can pass nodes from the atria through the ventricle is at the centre AV node. This is why we can introduce the AV node as a special electrical window or specialized electrical connection between the atria and the ventricle (Soltani et al 2022).…”

Photocatalytic degradation of methylene blue over MIL-100(Fe)/GO composites: a performance and kinetic study

“…Efficiently removing MB from water is an important issue and has aroused extensive attention in academic field during the past few years. Variety of physicochemical techniques have been explored to eliminate organic dyes from waste liquid, such as precipitation (Sabboh et al 2006), adsorption (Petit and Bandosz 2011), ion exchange (Horcajada et al 2006), photocatalysis (Soltani et al 2022) and electrochemical (Zhang et al 2020). Among the above methods, adsorption has been an excellent unit operation to be widely applied in industrial production owing to its low cost, convenient operation and low sensitivity to toxicants.…”