Effect Of Berberine On Cardiac Function, Serum Nitric Oxide And Proinflammatory Cytokines For Chronic Congestive Heart Failure Secondary To Dilated Cardiomyopathy

Objective To observe the effect of berberine on cardiac function,plasma nitric oxide and proinflammatory cytokines for chronic congestive heart failure(CHF) secondary to dilated cardiomyopathy(DCM).Method 45 patients with CHF secondary to DCM were studied in a single center.There were 3 patients in New York Heart Association(NYHA)functional classⅡ,18 in classⅢand 13 in classⅣ.Serum nitric oxide(NO)levels were measured by colorimetric methods.Plasma N-terminal pro-brain natriuretic peptide(NT-ProBNP)and Serum proinflammatory cytokines hign-sensitivity C-reactive protein(hsCRP),interleukin 6(IL-6)and tumornecrosis factor alpha(TNF-α)levels were determined by ELISA.Left ventricular ejection fraction(LVEF)was measured by ultrasonography.The results were compared with those of 20 healthy people.42 patients with LVEF＜50%were randomized to receive conventional therapy or berberine therapy.All patients with CHF secondary to DCM were followed up for 2 months.Results(1)Serum NO level of classⅢand classⅣwere higher than that in healthy people(both P＜0.01).Serum hsCRP level of classⅣwere higher than that in healthy people(P＜0.05).(2)LVEF of healthy people were higher than that in classⅢand classⅣ(P＜0.01).(3)Plasma NT-ProBNP level elevated with the increasing class of NYHA grade.There were significant differences for plasma NT-ProBNP level among the healthy people,classⅡ,classⅢand classⅣ(all P＜0.05).(4)NT-ProBNP correlated well with NYHA grade and LVEF (r=0.826,r=-0.772).(5)The event group had a higher plasma NT-ProBNP concentration(P＜0.00)and a lower LVEF(P＜0.05)than those in non-event group on admission.Serum level of NO,hsCRP,IL-6,TNF-αon admission were no statistical difference between the event group and non-event group.(6) The improvement of NYHA grade was no statistical difference between berberine and conventional group(P＞0.05),but Berberine group had significant increase in LVEF(P＜0.05)and significant decrease in plasma NT-ProBNP concentration(P＜0.00)compared with those in conventional group after 2 months treatment.(7)Serum NO and hsCRP concentration decreased significantly treated by berberine(both P＜0.05)Conclusion(1)Serum NO and hsCRP concentration could serve as the markers to judge the severity of CHF secondary to DCM.(2)Serum NT-ProBNP level should be superior to serum NO and proinflammatory cytokines level as the markers to evaluate the severity and the prognosis of CHF secondary to DCM. (3)The heart function of the patients with CHF secondary to DCM could be improved by Berberine.(4)Berberine could decrease serum NO and hsCRP concentration,maybe due to the improvement of cardiac function.