Cardiovascular actions of Radix Stephaniae Tetrandrae: a comparison with its main component, tetrandrine

A comparison of the cardiovascular actions of the extract of Radix Stephaniae Tetrandrae (RST), the root of a Chinese hero Stephania tetrandra S Moore, in rats with those of tetrandrine (Tet), the best known active component of RST was reviewed. The RST extract inhibits Ca2+ influx into the myocyte and reduces protein release during reperfusion with a Ca2+ containing solution following perfusion with a Ca2+ free solution (Ca2+ paradox), and arrhythmia during reperfusion in the isolated perfused heart. It also reduces the infarct size induced by ischemia/reperfusion in vitro and in vivo. In addition, the RST extract suppresses elevation of arterial blood pressure in DOCA-salt hypertensive rats. It does not further reduce the heart rate and coronary flow significantly during myocardial ischemia. The effects are similar to those of Tet. When compared with the same doses of Tet alone, the RST extract, of which 9% is Tet, produces equally potent effects on infarction, arrhythmias, coronary flow and heart rate, and has a greater inhibitory effect on protein release during Ca2+ paradox. The combination at 1:1 ratio of Tet and fangchinoline (Fan), another main component, which constitutes 6% of the RST extract and has no significant effects on the heart, produces comparable effects on protein release during Ca2+ paradox as Tet alone. The observations suggest that the efficacy of the RST extract cannot be accounted for by Tet alone. Some of the effects may be due to an interaction between the components of the extract. The RST extract also produces similar effects as verapamil, a prototype Ca2+ channel antagonist widely used in the treatment of ischemic heart diseases and hypertension, except that verapamil, at 1 mumol/L, a concentration that produces similar cardiac effects as the RST extract, further reduces heart rate significantly during ischemia. So the RST extract may be a therapeutically better agent in the treatment of ischemic heart diseases and hypertension than Ca2+ channel antagonists because of the absence of the inhibitory effect on heart rate during myocardial ischemia.