The protective effect of Er-Xian decoction against myocardial injury in menopausal rat model

Zhang, Zhiguo; Xiang, Lan; Zhao, Lei; Jiao, Hong; Wang, Zhen; Li, Yubo; Chen, Yanjing

doi:10.1186/s12906-018-2311-9

“…Zhang et al (2018) studied the therapeutic properties of EXD (Er-Xian Decoction), commonly found in Chinese medicine to treat menopausal syndrome [ 16 ]. After 12 weeks of treatment with EXD, a substantial improvement in cardiac function was observed.…”

Section: Reviewmentioning

confidence: 99%

“…After 12 weeks of treatment with EXD, a substantial improvement in cardiac function was observed. The Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed expression of genes in the ventricle which could play a part in decreasing the expression of mRNA, myosin, and integrin, thereby helping with cardiac contractility [ 16 ].…”

Section: Reviewmentioning

confidence: 99%

Cardioprotective Role of Estrogen in Takotsubo Cardiomyopathy

Waqar¹,

Jain²,

Joseph³

et al. 2022

Cureus

1

0

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Takotsubo cardiomyopathy (TC) is a rare, reversible cause of left ventricular wall motion abnormality (LVWMA) that mimics the presentation of acute myocardial infarction (AMI). TC is usually preceded by an emotional or physical stressor and appears to be more common in postmenopausal women. Various pathophysiological hypotheses of TC have been proposed, but the exact mechanism of action remains elusive. Elevated levels of catecholamines leading to cardiac dysfunction are the most prevalent hypothesis. The protective role of estrogen in the development of cardiomyopathies has been studied extensively. International Takotsubo Diagnostic Criteria (InterTAK) and Mayo clinic diagnostic criteria both have the stipulation stating prevalence of TC is higher in postmenopausal women which hints towards the protective role of estrogen in the development of TC. To review the protective role of estrogen in the mechanism of this novel pathology, we searched Pubmed and Google scholar for the relevant articles by using keywords such as: "takotsubo cardiomyopathy", "apical ballooning", "broken heart syndrome", "stress cardiomyopathy", "left ventricle wall motion abnormality", "estrogen", "estradiol" and "sex hormones". Our research revealed that although the prevalence of TC is greater in postmenopausal women as compared to men, the prognosis is worse in men. It also revealed the involvement of multiple cellular pathways under the influence of estrogen that could explain the cardioprotective effect of estrogen. Most of the articles found were based on animal studies, thus, there is an emphasis on future human studies. However, we strongly suggest evaluating estrogen levels as part of the initial workup for any patient presenting with signs and symptoms of cardiac pathology.

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“…Some studies on OVX rats show that EXD has the effect of increasing serum E 2 [ 22 , 23 ]. One research group assessing the effect of EXD on the cardiovascular system of OVX rats in the early stage found that the cardiac electrical activity of female OVX rats was abnormal, the electrophysiological properties of the myocardium were remodeled, the myocardium also had tissue structure remodeling, and myosin and other genes were also changed [ 24 ]. EXD can improve abnormal cardiac electrical activity in OVX rats, can regulate the expression of genes related to myocardial contraction, and has a protective effect on myocardial injury in OVX rats [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

“…One research group assessing the effect of EXD on the cardiovascular system of OVX rats in the early stage found that the cardiac electrical activity of female OVX rats was abnormal, the electrophysiological properties of the myocardium were remodeled, the myocardium also had tissue structure remodeling, and myosin and other genes were also changed [ 24 ]. EXD can improve abnormal cardiac electrical activity in OVX rats, can regulate the expression of genes related to myocardial contraction, and has a protective effect on myocardial injury in OVX rats [ 24 ]. Therefore, this study used OVX rats as the model to discuss the dynamic evolution of cardiac function, BP and its traditional risk factors, blood glucose, and blood lipids in rats after ovariectomy.…”

Section: Introductionmentioning

confidence: 99%

Dynamic Evolution of Cardiac Function and Glucose and Lipid Metabolism in Ovariectomized Rats and the Intervention Effect of Erxian Decoction

Wang

¹

,

Jiang

²

,

Hu

³

et al. 2022

Evidence-Based Complementary and Alternative Medicine

Self Cite

3

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Aims. Abnormal changes in cardiac function have been reported in menopausal women, but there are few clinical studies on this topic. Erxian decoction (EXD) is a classic prescription that is widely used in the treatment of female menopausal diseases. The purpose of this study was to investigate the dynamic evolution of cardiac function and glucose and lipid metabolism in ovariectomized (OVX) rats and the intervention effect of EXD. Materials and Methods. The OVX climacteric rat model was established by bilateral ovariectomy. After successful modeling, the rats were randomly divided into four groups: the sham operation (SHAM) group (equal volumes of purified water), OVX group (equal volumes of purified water), estradiol (E2) group (1.8 × 10−4 g/kg), and EXD group (9 g/kg). Each group of rats was treated for 16 weeks. At the 4th, 8th, 12th, and 16th weeks after treatment, the cardiac function of the rats in each group was evaluated by ultrasound. The coaxial method was used to measure blood pressure (BP). Serum endothelin-1 (ET-1) and angiotensin-2 (Ang II) levels were determined by the enzyme-linked immunosorbent assay (ELISA). The strip method was used to measure fasting blood glucose (FBG). The serum total cholesterol (TC) and triglyceride (TG) levels of rats were measured with the oxidase method. Direct methods were used to measure serum high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) levels. At week 16 of dosing, serum E2 levels were determined by E2 radioimmunoassay. The myocardium and uterus of the rats in each group were stained with HE (hematoxylin-eosin). The ultrastructure of the rat myocardium was observed by electron microscopy. Results. After the 16th week of treatment, the serum E2 level decreased ( P < 0.05 ), and the uterus was atrophied in OVX rats. The cardiac ejection fraction (EF%) decreased at 4 weeks after treatment, and systolic and diastolic function decreased after 12 weeks. After the 16th week, the EF%, which reflects the “pump” function of the heart, decreased significantly ( P < 0.05 or P < 0.01 ). At the 4th, 8th, 12th, and 16th weeks of treatment, the systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean pressure (MBP) of the rats in the OVX group increased with time ( P < 0.05 or P < 0.01 ). The serum ET-1 and Ang II levels of rats in the OVX group increased ( P < 0.05 or P < 0.01 ). In the OVX group, FBG was increased ( P < 0.05 or P < 0.01 ), and blood lipids, especially LDL-C, were significantly increased ( P < 0.05 or P < 0.01 ). After the 16th week of treatment, the myocardial tissue of OVX rats showed obvious pathological changes. EXD significantly increased serum E2 levels ( P < 0.01 ), decreased ET-1 and Ang II levels ( P < 0.01 ), reduced the cardiac function risk factors BP, FBG, and blood lipids, and significantly improved cardiac function and structural changes in OVX rats ( P < 0.05 or P < 0.01 ). Conclusions. EXD can improve abnormal cardiac structure and function in OVX rats.

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