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

https://doi.org/10.1016/S0002-9149(03)00533-2Get rights and content

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.

Section snippets

Patients

From January 1992 to May 2001, 156 patients with chronic CHF (94 men and 62 women) were studied in a single center; their mean age was 64 ± 14 years (range 45 to 96). There were 47 patients in New York Heart Association (NYHA) functional class II, 78 in class III, and 31 in class IV. In addition, they had frequent VPCs (>90 beats/hour) and/or nonsustained ventricular tachycardia (VT), defined as 3 consecutive beats but <30 beats. All patients had a decreased LVEF (22 ± 12%, range 10% to 34%)

Clinical results at 8 weeks

There was a greater improvement of cardiac function in patients treated with berberine than in the placebo group (NYHA classification from 2.9 ± 0.5 to 2.0 ± 0.3 in the treatment group vs 2.9 ± 0.5 to 2.4 ± 0.4 in placebo group, p <0.001.

Six-minute walking test and LVEF

After 8 weeks of treatment, there was a greater increase in 6-minute walking distance and LVEF in the berberine group than those treated with placebo (Table 2).

Table 3shows that there was a statistically significant difference in the aggregate score of

Discussion

In this study we found that treatment of patients with CHF with berberine was safe and beneficial. There was improved exercise capacity as evidenced by an increase in the 6-minute walking test. This may be partially due to the increase in LV function alone or together with a decrease in blood pressure. The latter is due to its α-adrenergic receptor effects and possibly a central sympathetic effect.11, 12, 13 Berberine also had a favorable effect on quality-of-life assessment. In addition, it

Acknowledgements

We gratefully acknowledge the assistance of Dr. Frank Marcus for his advice, with the design of this study and in writing the manuscript.

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