Abstract

BackgroundChronic heart failure (CHF), the final stage of various cardiovascular diseases, is a major public health problem resulting in significant hospitalization rates, mortality, and huge health care costs despite advances in the treatment and management of heart failure and heart failure-related risk factors. Qishen granules (QSG), a Chinese herbal formula, is widely used by traditional Chinese medicine (TCM) practitioners to treat CHF. Several animal experimental studies have showed that QSG can significantly relieve the heart failure symptoms in CHF rat models. However, there is as yet no standard clinical trial to confirm this. Thus, the investigators are conducting this study to evaluate the efficacy and safety of QSG in a large, and varied population.Methods/designThis study is designed as a randomized, placebo-controlled, multi-center, double-blind clinical trial with parallel groups. A total of 200 patients with CHF will be recruited and randomly allocated to either the QSG treatment group or the placebo group (in a 1:1 ratio). The patients will receive QSG or placebo granules twice a day for 12 weeks. The primary outcome is the proportion of patients in the QSG group, compared with the placebo group, demonstrating a more than 30% decrease in NT-proBNP level during 12 weeks of treatment. The secondary outcomes consist of composite cardiac events, New York Heart Association functional classification, 6-minute walking distance, left ventricular ejection fraction, patient quality of life, and the TCM syndrome integral scale.DiscussionOn a background of standard treatment, QSG may further reduce the levels of NT-proBNP. This trial will provide high-quality evidence on the efficacy and safety of QSG in treating CHF, thus providing reference for clinical application of QSG.Trial registrationClinical Trials.gov: NCT03027375. Registered on 16 January 2017.

Highlights

  • Chronic heart failure (CHF), the final stage of various cardiovascular diseases, is a major public health problem resulting in significant hospitalization rates, mortality, and huge health care costs despite advances in the treatment and management of heart failure and heart failure-related risk factors

  • The objective of this study is to evaluate the safety and efficacy of Qishen granules (QSG) in a large and varied CHF population

  • Myocardial fibrosis plays an important role in the development of heart failure [16]

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Summary

Introduction

Chronic heart failure (CHF), the final stage of various cardiovascular diseases, is a major public health problem resulting in significant hospitalization rates, mortality, and huge health care costs despite advances in the treatment and management of heart failure and heart failure-related risk factors. Several animal experimental studies have showed that QSG can significantly relieve the heart failure symptoms in CHF rat models. Mongolicus (Bge.) Hsiao, Salvia miltiorrhiza Bge., Lonicera japonica Thunb., Scrophularia ningpoensis Hemsl., Aconitum carmichaeli Debx., and Glycyrrhiza uralensis Fisch. This formula is widely used to treat the CHF of Qi deficiency and the blood stasis syndrome. Several animal experimental studies have showed the effect of QSG on the heart failure symptoms in CHF rat models [5,6,7,8,9], but there is yet no standard clinical evidence. The investigators have designed a clinical study to assess the efficacy and safety of QSG in a large and varied population

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