Cardiovascular effects of berberine in patients with severe congestive heart failure
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Abstract Berberine, an alkaloid of the protoberberine family, has been shown to have strong positive inotropic and peripheral resistance‐lowering effects in dogs with and without heart failure. To determine the acute cardiovascular effects of berberine in humans, 12 patients with refractory congestive heart failure were studied before and during berberine intravenous infusion at rates of 0.02 and 0.2 mg/kg per min for 30 minutes. The lower infusion dose produced no significant circulatory changes, apart from a reduction in heart rate (14%). The 0.2 mg/kg per min dose elicited several significant changes: (a) Decreases in systemic (48%, p>0.01) and pulmonary vascular resistance (41%, p>0.01), and in right atrium (28%, p>0.05) and left ventricular end‐diastolic pressures (32%, p>0.01). (b) Increases in cardiac index (45%, p>0.01), stroke index (45%, p>0.01), and LV ejection fraction measured by contrast angiography (56%, p>0.01). (c) Increases in hemodynamic and echocardiographic indices of LV performance: peak measured velocity of shorten: ing (45%, p>0.01), peak shortening velocity at zero load (41%, p>0.01), rate of development of pressure at developed isovolumic pressure of 40 mmHg (20%, p>0.01), percent fractional shortening (50%, p>0.01), and the mean velocity of circumferential fiber shortening (54%, p>0.01). (d) Decrease of arteriovenous oxygen difference (28%, p>0.05) with no changes in total body oxygen uptake, arterial oxygen tension, or hemoglobin dissociation properties. These salutary acute effects show that berberine markedly improved cardiac performance in patients with heart failure refractory to conventional medical therapy with digitalis and diuretics. The improvement is probably subsequent to peripheral vasodilatation and to inotropic stimulation. Significant untoward effects appear to be the development of ventricular tachycardia with “torsades de pointes” morphology, detected in 4 patients 1‐20 h after the infusion of berberine. This possible association requires further elucidation before the administration of berberine may be extended to other patients in heart failure.
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Berberine's hemodynamic effects are documented even in patients with severe heart failure.
“hemodynamic effects documented even in patients with severe heart failure [88].”
From Berberine-Drug Interactions: Mechanisms, Clinical Relevance and Risk Stratification-A Narrative Review (2026) · cites this paper as [88]
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- Authors
- Marin ‐ NETO, J. A., Maciel, B. C., Secches, A. L., & Gallo, L.
- Affiliations
- Universidade de São Paulo (BR)
- ORCID
- Maciel, B. C.
- Venue
- Clinical Cardiology
- Publisher
- Wiley
- Published
- 1988-04
- Volume
- 11
- Issue
- 4
- Pages
- 253-260
- ISSN
- 0160-9289 (ISSN-L)
- 1932-8737
- OpenAlex
- W2063518321
- Cited by
- 128
- References
- 17
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 3 · 2023: 10 · 2022: 4 · 2021: 9 · 2020: 7 · 2019: 4 · 2018: 4 · 2017: 5 · 2016: 9 · 2015: 8 · 2014: 5 · 2013: 12 · 2012: 3
- FWCI
- 0.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Fundação de Amparo à Pesquisa do Estado de São Paulo
- Topics
- Health Sciences › Medicine › Pharmacology › Berberine and alkaloids research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
- Keywords
- berberine, congestive heart failure, refractory heart failure, cardiovascular effects, inotropic effect, vasodilation, pulmonary vascular resistance, left ventricular ejection fraction, cardiac function, ventricular tachycardia, torsades de pointes, diuretic resistance, cardiac index, arteriovenous oxygen difference, intravenous infusion, adverse drug reactions
- MeSH terms
- Adult, Aged, Berberine, Berberine Alkaloids, Echocardiography, Electrocardiography, Female, Heart Failure, Hemodynamics, Humans, Male, Middle Aged, Tachycardia
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