Herbal medicines for viral myocarditis

Area of Science:

• Cardiology
• Pharmacology
• Integrative Medicine

Background:

• Viral myocarditis is a significant health concern, with herbal medicines increasingly explored for treatment.
• Numerous controlled trials have investigated the efficacy of various herbal remedies for viral diseases.

Purpose of the Study:

• To systematically assess the clinical and indirect outcomes of herbal medicine interventions in patients diagnosed with viral myocarditis.
• To evaluate the effectiveness and safety of herbal medicines as a therapeutic option for viral myocarditis.

Main Methods:

• A comprehensive search of multiple databases (CENTRAL, MEDLINE, EMBASE, etc.) and handsearched Chinese literature was conducted.
• Included were randomized controlled trials (RCTs) of herbal medicines (≥7 days treatment) versus placebo, no intervention, or conventional treatments, including add-on therapy.
• Data extraction and quality assessment were performed independently by two reviewers, with efforts to obtain additional information from study authors.

Main Results:

• Forty RCTs involving 3448 participants were analyzed, all originating from China with generally low methodological quality.
• Key findings indicated that Astragalus membranaceus, Salviae miltiorrhizae injection, and Shenmai/Shengmai injection (Ginseng) demonstrated significant positive effects.
• These effects included improvements in arrhythmia, creatine phosphokinase (CPK) levels, cardiac function, and reduction of lactate dehydrogenase (LDH) levels, with no serious adverse effects reported.

Conclusions:

• Certain herbal medicines exhibit potential anti-arrhythmic effects in suspected viral myocarditis cases.
• The current evidence, while promising, must be interpreted cautiously due to methodological limitations and small sample sizes for individual herbs.
• Further high-quality, rigorous clinical trials are warranted to validate the efficacy and safety of these herbal interventions.