NIS - libdoc.who.int - World Health Organization

WHO monographs on medicinal plants commonly used in the Newly Independent States (NIS)
oxygen deficiency, have antiarrhythmic effects and reduce afterload (29).
Positive therapeutic effects of Folium cum Flore Crataegi in patients with
characteristic symptoms of an activated sympathoadrenergic system, such
as hypertension, tachycardia and arrhythmia (also characteristic of cardiac
insufficiency stage II, as defined by the New York Heart Association (25–
34)), have also been demonstrated (30). Furthermore, numerous clinical
trials with and without controls have assessed the therapeutic efficacy of
Folium cum Flore Crataegi extracts for the treatment of cardiac insufficiency
stage II (25–34). The investigations were performed with a dried
70% methanol or 45% ethanol standardized extract (containing 2.2% flavonoids
or 18.75% oligomeric procyanidins, respectively) of the leaves
with flowers (30). The dosage ranged from 160 to 900 mg extract daily for
4–8 weeks. Evaluation of efficacy of the extracts was based on the following
criteria: anaerobic threshold (27); Clinical Global Impression Scale (31,
32); exercise tolerance (25, 26, 28, 31, 32, 34); ventricular ejection fraction
(26, 33); quality of life and improvement of subjective symptoms (defined
by the New York Heart Association) (26–28, 31–34) and pressure/rate
product (26, 28, 31, 32, 34). Although improvements were seen, no longterm
trials have assessed the effects of Folium Cum Flore Crataegi on
mortality rates in patients with chronic congestive heart failure.
Exercise tolerance
A randomized, double-blind, placebo-controlled trial assessed the efficacy
of the extract containing 2.2% flavonoids on exercise-induced anaerobic
threshold, as measured by spiroergometry, in 72 patients. Patients were
administered an oral dose of 900 mg extract or placebo daily for 8 weeks.
After treatment, oxygen uptake increased significantly in the treated group
(P < 0.05), and exercise time to anaerobic threshold increased by 30 seconds
in the treated group, but by only 2 seconds in the placebo group.
Significant improvements in subjective symptoms were also noted in the
treated group, as compared with the placebo group (P < 0.01) (27).
The efficacy of the extract containing 2.2% flavonoids on the improvement
of exercise tolerance was assessed by bicycle ergometry in patients
with cardiac insufficiency stage II, in three clinical trials. In a doubleblind,
placebo-controlled trial of 85 patients, oral administration of 300 mg
extract daily for 4–8 weeks improved working capacity; however, the difference
was not significant when compared with the placebo (25). A double-blind,
placebo-controlled trial assessed the efficacy of oral administration
of 600 mg extract daily for 8 weeks in 78 patients. Patients in the
treatment group had a significant improvement in exercise tolerance as
compared with the placebo group (P < 0.001). Patients who received the
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