Traditional Chinese Medicine YangxinDingji alleviates arrhythmias through inhibition of sodium and L-type calcium channels

  • J Ethnopharmacol. 2025 May 12:347:119803. doi: 10.1016/j.jep.2025.119803.
Suhua Qiu  1 ,  Jinglei Sun  2 ,  Shi Su  3 ,  Wenting Wu  4 ,  Jiali Zhang  5 ,  Jinlong Qi  6 ,  Yanfang Xu  7
Affiliations
  • 1. Department of Pharmacology, Hebei Medical University, Shijiazhuang, 050017, China; Key Laboratory of New Drug Pharmacology and Toxicology, Shijiazhuang, 050017, China; Key Laboratory of Neural and Vascular Biology, Ministry of Education, Shijiazhuang, 050017, China. Electronic address: [email protected].
  • 2. Department of Pharmacology, Hebei Medical University, Shijiazhuang, 050017, China; Key Laboratory of New Drug Pharmacology and Toxicology, Shijiazhuang, 050017, China; Key Laboratory of Neural and Vascular Biology, Ministry of Education, Shijiazhuang, 050017, China. Electronic address: [email protected].
  • 3. Department of Pharmacology, Hebei Medical University, Shijiazhuang, 050017, China; Key Laboratory of New Drug Pharmacology and Toxicology, Shijiazhuang, 050017, China; Key Laboratory of Neural and Vascular Biology, Ministry of Education, Shijiazhuang, 050017, China. Electronic address: [email protected].
  • 4. Department of Pharmacology, Hebei Medical University, Shijiazhuang, 050017, China; Key Laboratory of New Drug Pharmacology and Toxicology, Shijiazhuang, 050017, China; Key Laboratory of Neural and Vascular Biology, Ministry of Education, Shijiazhuang, 050017, China. Electronic address: [email protected].
  • 5. Department of Pharmacology, Hebei Medical University, Shijiazhuang, 050017, China; Key Laboratory of New Drug Pharmacology and Toxicology, Shijiazhuang, 050017, China; Key Laboratory of Neural and Vascular Biology, Ministry of Education, Shijiazhuang, 050017, China. Electronic address: [email protected].
  • 6. Department of Pharmacology, Hebei Medical University, Shijiazhuang, 050017, China; Key Laboratory of New Drug Pharmacology and Toxicology, Shijiazhuang, 050017, China; Key Laboratory of Neural and Vascular Biology, Ministry of Education, Shijiazhuang, 050017, China. Electronic address: [email protected].
  • 7. Department of Pharmacology, Hebei Medical University, Shijiazhuang, 050017, China; Key Laboratory of New Drug Pharmacology and Toxicology, Shijiazhuang, 050017, China; Key Laboratory of Neural and Vascular Biology, Ministry of Education, Shijiazhuang, 050017, China. Electronic address: [email protected].
PMID: 40239882 DOI: 10.1016/j.jep.2025.119803
Abstract

Ethnopharmacological relevance: The Chinese herbal formula YangxinDingji (YXDJ), derived from the classic ancient formula Zhigancao decoction that originated from Zhang Zhongjing's "shang han lun", is a modern preparation of a classic prescription, and is used for arrhythmia treatment in China. However, its antiarrhythmic mechanisms are not fully elucidated.

Aim of the study: This study aimed to investigate the pharmacological and molecular mechanisms of YXDJ.

Materials and methods: Antiarrhythmic effects were evaluated in isolated guinea pig hearts subjected to ischemia/reperfusion (I/R) or isoproterenol (ISO) challenge, and in human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) utilizing a multi-electrode array (MEA). Patch clamp recordings assessed the effects of YXDJ on sodium (INa, INa-L) and L-type calcium (ICa-L) currents, while potassium currents (IKr, IKs) were studied in heterologous cells. Optical mapping observed electrical activities and calcium transients.

Results: YXDJ pretreatment at concentrations of 0.25, 0.5, and 1.0 mg/ml effectively prevented ventricular arrhythmias induced by I/R or ISO challenge, and mitigated electrical stimulation-induced arrhythmias in hiPSC-CMs. YXDJ inhibited INa, INa-L, and ICa-L currents in a concentration-dependent manner without affecting IKr and IKs, inhibited abnormal electrical activities and excitation reentry, decreased action potential duration dispersion and heterogeneity of excitation conduction, and restored intracellular calcium homeostasis.

Conclusions: Our results demonstrate that YXDJ exerts its antiarrhythmic effect through the inhibition of inward depolarizing currents, which prevents alterations in left ventricular repolarization dispersion. This leads to synchronized repolarization and a reduction in excitation reentry. Collectively, these findings suggest that YXDJ is a promising candidate for the treatment of arrhythmias.

Keywords
Arrhythmias; Calcium homeostasis; I(Ca-L); I(Na-L); YangxinDingji.
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