Abstract

Ischemic heart disease has a high mortality, and the recommended therapy is reperfusion. Nevertheless, the restoration of blood flow to ischemic tissue leads to further damage, namely, myocardial ischemia/reperfusion injury (MIRI). Apoptosis is an essential pathogenic factor in MIRI, and ginsenosides are effective in inhibiting apoptosis and alleviating MIRI. Here, we reviewed published studies on the anti-apoptotic effects of ginsenosides and their mechanisms of action in improving MIRI. Each ginsenoside can regulate multiple pathways to protect the myocardium. Overall, the involved apoptotic pathways include the death receptor signaling pathway, mitochondria signaling pathway, PI3K/Akt signaling pathway, NF-κB signaling pathway, and MAPK signaling pathway. Ginsenosides, with diverse chemical structures, regulate different apoptotic pathways to relieve MIRI. Summarizing the effects and mechanisms of ginsenosides contributes to further mechanism research studies and structure–function relationship research studies, which can help the development of new drugs. Therefore, we expect that this review will highlight the importance of ginsenosides in improving MIRI via anti-apoptosis and provide references and suggestions for further research in this field.

Highlights

  • Ischemic heart disease (IHD) is characterized by insufficient blood flow to the cardiac tissue (Querio et al, 2021)

  • Evidence indicated that the death rate of acute myocardial infarction (AMI) patients treated with optimal reperfusion therapy was approximately 7% (Hausenloy and Yellon, 2016)

  • myocardial ischemia/reperfusion injury (MIRI) is functional and organic damage to the heart, which results from restoration of blood flow in ischemic areas (Wang K. et al, 2021)

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Summary

Introduction

Ischemic heart disease (IHD) is characterized by insufficient blood flow to the cardiac tissue (Querio et al, 2021). Previous evidence indicated that ginsenosides could improve myocardial cell (MC) apoptosis to promote cardiac functions and reduce infarct size in MIRI It was demonstrated that the three types of ginsenosides were effective in inhibiting MC apoptosis and regulating different apoptotic pathways to relieve MIRI.

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