ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Ethnopharmacology
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1650293
This article is part of the Research TopicNew Frontiers in Heart Failure Therapy: Mechanisms, Efficacy, and ChallengesView all 10 articles
Efficacy of Plant Extracts in Heart Failure Patients: A systematic review and network meta-analysis
Provisionally accepted- 1Dongguan Children's Hospital Affiliated to Guangdong Medical University, Dongguan, China
- 2Guangdong Medical University, Zhanjiang, China
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Objective: This study aimed to evaluate the therapeutic efficacy of plant extracts in patients with heart failure.: A systematic search was conducted in PubMed, EMBASE, Cochrane Library, and Web of Science to identify randomized controlled trials (RCTs) investigating the effects of plant extracts on heart failure patients. The search period spanned from database inception to June 2024. The methodological quality of the included studies was assessed using the Cochrane Risk of Bias Tool. Statistical analyses were performed using Review Manager 5.3 and Stata 15.1. Results: A total of 28 studies involving 3,650 heart failure patients were included. Network meta-analysis examined 15 distinct plant extracts: Panax ginseng and Ophiopogon japonicus extract, Water extract of stem bark of Terminalia arjuna, Astragalus extract, Panax ginseng extract, Red ginseng extract, Astragalus and Codonopsis extract, Hawthorn extract, Red ginseng Ophiopogon japonicus and Schisandra extract, Ginkgo biloba extract, Salvia miltiorrhiza extract, Rhodiola extract, Panax ginseng and Aconite extract, Centaurea behen extract, Oak wood extract, and Berberine extract. Based on the Surface Under the Cumulative Ranking Curve (SUCRA) values, Water extract of stem bark of Terminalia arjuna ranked first in Number of patients with improved New York Heart Association (NYHA) classification. Salvia miltiorrhiza extract exhibited the highest efficacy in enhancing left ventricular ejection fraction (LVEF), while Oak wood extract demonstrated optimal improvement in quality of life (QoL). Astragalus extract showed superior efficacy in the six-minute walk test (6MWT). Conclusion: In summary, our study supports the potential therapeutic value of plant extracts in the treatment of heart failure. According to SUCRA rankings, plant extracts may serve as an effective adjunctive therapy to improve cardiac function, QoL, and prognosis in heart failure patients. Highlighting the distinct therapeutic advantages of different plant extracts for heart failure management. However, the limited number of studies for certain interventions and the scarcity of direct comparative evidence warrant cautious interpretation of the findings. Future research should prioritize larger-scale, high-quality RCTs to validate and supplement these results.
Keywords: Plant Extracts, Heart Failure, Network meta-analysis, NYHA, LVEF, 6MWT, QOL
Received: 19 Jun 2025; Accepted: 06 Aug 2025.
Copyright: © 2025 Tang, Li, Wu, Xie and Liang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Mengxin Xie, Dongguan Children's Hospital Affiliated to Guangdong Medical University, Dongguan, China
Hongsheng Liang, Dongguan Children's Hospital Affiliated to Guangdong Medical University, Dongguan, China
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