Beneficial effects of Terminalia arjuna in coronary artery disease

Effect of Terminalia arjuna on angina pectoris, congestive heart failure and left ventricular mass was studied in patients of myocardial infarction with angina and/or ischaemic cardiomyopathy. Bark stem powder of T. arjuna, 500 mg 8 hourly was administered to 10 patients of postmyocardial infarction angina and two patients of ischaemic cardiomyopathy, in a dose of 500 mg 8 hourly postoperatively, for a period of three months (Group A). These patients were also on conventional treatment comprising of nitrates, aspirin and/or calcium channel blockers. Twelve age-, sex-, body mass index- and ECG-matched patients of postmyocardial infarction angina receiving only conventional treatment served as controls (Group B). Significant reduction in anginal frequency was noted in both groups (3.5 +/- 1.98 to 1.08 + 1.08 per day vs 3.10 + 0.72 to 1.17 + 0.84 per day). However, only Group A patients showed significant improvement in left ventricular ejection fraction (42.25 + 9.96 to 52.67 + 12.32% vs 51.83 + 5.99 to 49.83 + 2.52%) and reduction in left ventricular mass (159.18 + 51.11 to 127.47 + 52.40 gm/m2 vs 159.11 + 38.92 to 160.78 + 54.23 gm/m2) on echocardiography following three months of therapy. Both patients with ischaemic cardiomyopathy showed significant symptomatic relief in coronary heart failure from NYHA class III to NYHA class I. Prolonged administration of T. arjuna did not show any adverse effects on renal, hepatic and haematological parameters. The potential of T. arjuna to improve left ventricular ejection fraction and reduce left ventricular mass in coronary artery disease needs to be harnessed.