Acute
Hemodynamic Effects of CardioPhase on Patients with Congestive
Heart Failure
Zhu Jia-Qing, Wang Wen-mao,
Du Xiao-yang, Yang Ding-yi, Wang Yu-ben, Wang Jian-xin, Cardiovascular
Department, First Affiliated Hospital of Xi’an Jiaotong
University, Xi’an 710061, China
Abstract: The acute hemodynamic effects of
CardioPhase on 32 patients with congestive heart failure (CHF)
were studied at different dosage levels. Treatment groups
were given a single dose of 20ml, 40 ml, or 100 ml oral CardioPhase
with a control group receiving only water. After establishing
baseline readings in heart rate, blood pressure, mean right
atria1 pressure (MRAP), mean pulmonary arterial pressure (MPAP),
pulmonary wedge pressure (PWP) and cardiac index (CI) readings
were taken on these hemodynamic parameters every hour for
eight hours.
Single doses of water or 20
ml of CardioPhase did not lead to statistically significant
changes in any of the measured readings.
In the treatment groups receiving
40 ml and 100 ml of CardioPhase the mean pulmonary arterial
pressure (MPAP) and pulmonary wedge pressure (PWP) of the
patients were statistically reduced, while their cardiac indexes
(CI) were elevated markedly (P<0.05). Such effects can
last for 4 hours. Heart rate and blood pressure were not changed
by these doses. The study suggests that CardioPhase can be
given to treat chronic CHF three times per day at an oral
dosage of 40 ml per time.
Study
Population
In all, 32 patients with chronic heart failure [CHF] (23 male,
9 female, mean age 35 years old ranging from 18~73 years old)
were studied, including 8 patients with ischemic cardiomyopathy
and 24 with dilated cardiomyopathy.
Method
Patients were hospitalized for catheterization of the pulmonary
artery using a 7F catheter (Swan-Ganz) to allow direct measurement
of mean pulmonary arterial pressure (MPAP), pulmonary wedge
pressure (PWP), mean right atrial pressure (MRAP), cardiac
index (CI), blood pressure (BP) and heart rate (HR).
Patients were divided into
treatment and control groups. The patients in the treatment
group received either 100, 40 or 20 ml of oral CardioPhase.
The 6 patients in the control group were treated with 100
ml of drank water. Following administration hemodynamic parameters
were measured every hour for the following eight hours.
Hemodynamic
Effect on Congestive Heart Failure
As shown in Tables 1 through 3, 1to 4 hours after
orally ingesting either 100 ml or 40 ml of CardioPhase, MPAP
and PWP of patients in the CardioPhase treated groups were
markedly reduced when compared with those before treatment
(P< 0.05 or P< 0.01). Additionally cardiac index (CI)
was remarkably increased in the CardioPhase treated groups
(P< 0.05 or P< 0.01). There was no significant difference
of hemodynamic parameters in patients receiving 20 ml of CardioPhase
(P>0.05).
Table 1. 100 ml CardioPhase
| Time
(hours) |
Heart
Rate
(times/min) |
BP
(mmHg) |
MRAP
(kPa) |
MPAP
(kPa) |
PWP
(kPa) |
CI |
| SBP |
DBP |
| Before treatment |
99±8 |
114.0±23.3 |
77.3±15.8 |
1.0±0.9 |
4.6±1.0 |
3.2±0.9 |
2.4±0.5 |
Hour 1 |
96±8 |
114.0±20.3 |
75.8±24.8 |
0.9±0.7 |
3.7±0.7** |
2.4±0.8** |
2.8±0.6** |
Hour 2 |
96±3 |
112.0±23.3 |
78.8±15.0 |
0.9±0.7 |
3.6±0.8** |
2.4±0.8** |
3.0±0.6** |
Hour 3 |
95±8 |
111.8±20.3 |
78.0±15.0 |
0.9±0.6 |
3.8±0.9** |
2.5±0.8** |
3.0±0.5** |
Hour 4 |
95±5 |
111.8±15.0 |
77.3±17.3 |
0.8±0.6 |
4.2±0.9* |
2.8±0.8* |
2.6±0.6* |
Hour 5 |
95±8 |
110.3±18.8 |
75.0±14.3 |
0.9±0.7 |
4.4±1.0 |
3.0±0.9 |
2.5±0.6 |
Hour 8 |
100±7 |
110.3±20.3 |
75.8±15.8 |
0.9±0.7 |
4.6±0.8 |
3.1±0.8 |
2.3±0.5 |
SBP, systolic
pressure; DBP, diastolic pressure
in mmHg. MRAP, MPAP,
PWP in kPa.
* P<0.05, **P<0.01 compared with those before
treatment.
Table 1. Hemodynamic effects of
100 ml oral CardioPhase on patients with CHF ( ±s).
|
Table 2. 40 ml CardioPhase
| Time
(hours) |
Heart
Rate
(times/min) |
BP
(mmHg) |
MRAP
(kPa) |
MPAP
(kPa) |
PWP
(kPa) |
CI |
| SBP |
DBP |
| Before treatment |
98±7 |
116.3±20.3 |
78.8±12.0 |
1.1±0.9 |
4.7±1.0 |
3.2±0.8 |
2.4±0.5 |
Hour 1 |
97±8 |
114.0±18.0 |
78.0±9.8 |
1.0±0.8 |
4.0±0.9 |
2.6±0.8* |
2.7±0.4* |
Hour 2 |
95±6 |
114.8±18.8 |
77.3±7.5 |
0.9±0.8 |
4.0±0.9* |
2.7±0.8* |
2.6±0.5* |
Hour 3 |
96±7 |
117.0±21.8 |
75.8±9.8 |
0.9±0.9 |
4.0±0.8* |
2.8±0.8* |
2.7±0.5* |
Hour 4 |
98±5 |
117.8±18.0 |
78.0±17.3 |
1.0±0.7 |
4.1±0.9* |
2.7±0.8* |
2.7±0.4* |
Hour 5 |
96±7 |
114.8±20.3 |
77.3±9.8 |
0.9±0.8 |
4.4±1.0 |
3.0±0.8 |
2.5±0.5 |
Hour 8 |
97±6 |
117.8±18.0 |
75.8±6.8 |
1.0±0.9 |
4.6±0.9 |
3.2±0.8 |
2.5±0.5 |
SBP, systolic
pressure; DBP, diastolic pressure
in mmHg. MRAP, MPAP,
PWP in kPa.
* P<0.05, **P<0.01 compared with those before
treatment.
Table 2. Hemodynamic effects of
40 ml oral CardioPhase on patients with CHF ( ±s).
|
Table 3. 20 ml CardioPhase
| Time
(hours) |
Heart
Rate
(times/min) |
BP
(mmHg) |
MRAP
(kPa) |
MPAP
(kPa) |
PWP
(kPa) |
CI |
| SBP |
DBP |
| Before treatment |
97±10 |
116.3±21.8 |
81.8±9.8 |
1.1±0.6 |
4.6±0.6 |
3.0±0.5 |
2.5±0.4 |
Hour 1 |
94±12 |
108.0±18.8 |
83.3±12.0 |
1.0±0.5 |
4.3±0.6 |
2.9±0.5 |
2.5±0.4 |
Hour 2 |
96±8 |
111.8±20.3 |
80.3±8.3 |
0.9±0.6 |
4.4±0.5 |
3.0±0.5 |
2.5±0.4 |
Hour 3 |
98±13 |
114.0±21.0 |
83.3±12.8 |
0.9±0.6 |
4.5±0.6 |
3.1±0.6 |
2.5±0.4 |
Hour 4 |
97±11 |
110.3±18.0 |
78.0±11.3 |
1.0±0.5 |
4.6±0.6 |
2.9±0.6 |
2.6±0.4 |
Hour 5 |
96±10 |
114.0±26.3 |
78.8±11.3 |
0.9±0.4 |
4.2±0.5 |
2.8±0.6 |
2.5±0.4 |
Hour 8 |
96±9 |
114.8±21.8 |
80.3±14.3 |
1.0±0.6 |
4.3±0.6 |
3.0±0.6 |
2.4±0.4 |
SBP, systolic
pressure; DBP, diastolic pressure
in mmHg. MRAP, MPAP,
PWP in kPa.
Table 3. Hemodynamic effects of
20 ml oral CardioPhase on patients with CHF ( ±s).
|
Table 4. 100 ml Water
| Time
(hours) |
Heart
Rate
(times/min) |
BP
(mmHg) |
MRAP
(kPa) |
MPAP
(kPa) |
PWP
(kPa) |
CI |
| SBP |
DBP |
| Before treatment |
96±15 |
114.8±24.0 |
80.3±12.0 |
1.2±0.5 |
4.7±0.6 |
3.1±0.5 |
2.6±0.3 |
Hour 1 |
92±13 |
105.8±26.3 |
72.0±15.0 |
0.9±0.4 |
4.6±0.6 |
2.9±0.5 |
2.7±0.2 |
Hour 2 |
93±10 |
108.0±26.3 |
69.8±14.3 |
1.0±0.5 |
4.4±0.5 |
2.9±0.5 |
2.7±0.3 |
Hour 3 |
93±13 |
107.3±27.0 |
72.0±12.8 |
0.8±0.4 |
4.5±0.5 |
2.9±0.4 |
2.7±0.4 |
Hour 4 |
94 |
108.0±26.3 |
72.0±12.8 |
0.8±0.3 |
4.5±0.5 |
2.9±0.4 |
2.8±0.3 |
Hour 5 |
97±10 |
108.0±32.3 |
69.0±12.0 |
0.8±0.4 |
4.5±0.4 |
3.0±0.3 |
2.8±0.3 |
Hour 8 |
92±12 |
110.3±24.8 |
78.0±12.8 |
0.9±0.4 |
4.6±0.3 |
3.0±0.4 |
2.7±0.3 |
SBP, systolic
pressure; DBP, diastolic pressure
in mmHg. MRAP, MPAP,
PWP in kPa.
Table 4. Hemodynamic effects of
100 ml water on patients with CHF ( ±s).
|
Discussion
CardioPhase, composed of huangqi
(Radix Astragali), shengdi (Radix Rehanniae),
guizhi (Ramulus Cinnamomi) etc., is an oral compound
product prepared by traditional Chinese methods. The formula
possesses the effects of nourishing cardiocytes and improving
both oxygen and blood supply to cardiocytes under conditions
such as anoxia and ischemia. CardioPhase can also protect
live cardiocytes an alleviate myocardial necrosis by increasing
myocardial tolerance against ischemia and necrosis. Thus,
CardioPhase is effective in treatment of myocardial ischemic
damage caused by various organic heart diseases such as coronary
artery disease (CAD), argina pectoris, myocarditis (MC), cardiomyopathy
etc.[1].
It has been reported that [2,
3], herbs like huangqi (Radix Astragali), guizhi
(Ramulus Cinnamomi) have the effect of strengthening
myocardial contractile force. Meanwhile, huangqi (Radix
Astragali) can alleviate heart preload and afterload
through reducing blood volume by promoting urination. In recent
years there have been several reports about the effect of
huangqi (Radix Astragali) on improving cardiac function.
Our experimental results show that 100 ml or 40 ml oral CardioPhase
can reduce MPAP and PWP, and increase CI (P<0.05) remarkably
for 4 hours. Our study suggests that CardioPhase can be used
to treat chronic CHF with 40 ml per time by mouth, taken three
times a day. As the main purpose of this experiment is to
investigate the acute hemodynamic effects of CardioPhase on
patients with CHF, the long-term effects of CardioPhase need
further abservation.
References
1. Wang Wen-mao, Liang Li-de, Du Xiao-yang. Clinical trial
of CardioPhase for myocardial ischemia. Shaanxi Medical Journal,
1992; 21 (8): 458
2. Yu Tian-xi, GU Shuang-lin. Clinical and experimental study
of heart hemodynamic effects of Ophiopgon japonicus on myocardial
ischemia. Shanghai Journal of Traditional Chinese Medicine,
1985; 3 (12): 30
3. Li Wen-ping. The effect of Ophiopogon injection on Cyclic
Nucleotide Metebolism in experimental myocardial infarction.
Jorunal of Integrated Traditional Chinese and Western Medicine,
1989; 9(2):100
4. Ren Wei, Ahu Hua-wen, Zhang Dong-xian. Clinical observation
of Milkvetch Root in treatment of cardiac insufficiency in
viral myocarditis. Chinese Journal of Critical Care Medicine,
1991; 11 (3): 38. |
