Hawthorn extract to improve the state of mind

In everyday practice, palpitations, thoracic symptoms, decreased performance, and dyspnea are the most common functional cardiac complaints. After exclusion of prognostically relevant clinical pictures, the question arises as to the further procedure. In patients seeking treatment, the use of phytotherapeutics has been shown to improve well-being. A herbal therapy option approved by the health insurance system in Switzerland is hawthorn extract in tablet form.

By definition, functional complaints are characterized by the fact that no sufficient organic cause can be identified [1,2]. The use of phytotherapeutics has a long tradition in medical history and is a treatment approach with high patient acceptance. In Switzerland, hawthorn extract ^WS®1442 (^Cardiplant® 450) is approved for the indication “nervous heart complaints” [5].

Overview of common symptoms of functional heart complaints

Palpitations can manifest as “heart palpitations,” “racing heart,” or “strong heartbeat.” Prognostically benign palpitations require the following: structurally normal heart (unremarkable echocardiography), no higher-grade arrhythmias (normal long-term ECG), no relevant underlying disease. The most common form of benign palpitations is symptomatic extrasystole.

Thoracic discomfort (pain/pressure/numbness) frightens patients. Accordingly, this reason for consultation is very common in family practice, accounting for 4-10% of all physician visits. By means of targeted questioning, clinical examination and the use of selected procedures (e.g. electrocardiogram, blood test, imaging), about 90% of all situations can be classified as harmless without the need for further clarification.

Performance Decrease/Dyspnea: Target values of physical performance are calculated based on age, height/weight, and gender. Physical performance is quantified using MET (“Metabolic Equivalent of Task”), where 1 MET corresponds to energy expenditure (measured as oxygen uptake capacity _VO2) at rest. This allows the energy requirements of different physical activities to be compared with reference to corresponding standard values [3,4]. In the absence of prognostically relevant diseases, which must be ruled out by specific clarification, about 80% of patients with the above symptoms are reassured and there is no need for further therapeutic action. However, some of those affected show considerable subjective suffering and wish to have their symptoms treated.

What are the mechanisms of action of ^Cardiplant® 450?

The phytotherapeutic ^WS®1442(^Cardiplant® 450), approved in Switzerland for the indication “nervous heart complaints”, contains 450 mg dry extract of hawthorn leaves and flowers in one film-coated tablet. The pharmacological effect of ^WS®1442is based on the increase of intracellular calcium concentration, which may have a positive inotropic effect, but also shows an antiarrhythmic effect [11–14]. In addition, ^WS®1442acts positively dromotropic (increases excitation conduction) and negatively bathmotropic (decreases excitation generation). Furthermore, ^WS® 1442 promotes NO release from erythrocytes and the endothelium, which has a vasorelaxant effect and can thus improve coronary perfusion [15–17].

Literature:

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