Ischemic heart disease is characterized by insufficient blood supply to the heart tissue. Therefore, one therapeutic strategy for treating ischemic heart failure is to restore blood supply by stimulating the growth of new blood vessels. Studies have shown that various angiogenic growth factors and progenitors, including vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF), recombinant proteins, and bone marrow stem cells, can enhance new blood vessels and stimulate angiogenesis. Certain components of Chinese herbs (Chinese herbal medicine store) have been shown to promote the development of new blood vessels. Shumai Decoction is a kind of Chinese medicine for treating ischemic heart disease, which is composed of seven kinds of drugs. The main active components of Shumai Decoction are astragaloside, salvianolic acid, ginsenoside Rg1 and so on. One study showed that Shumai Decoction significantly increased capillary and arteriole density, alleviated myocardial fibrosis, up-regulated phosphorylation of cardiac protein kinase B (Akt), and increased expression of VEGF and platelet-derived growth factor (PDGF-BB). These effects may be mediated by activation of the phosphoinositol 3-kinase (PI3K) /Akt signaling pathway in AMI rat models. Ginsenoside Rg1 can also promote angiogenesis and alleviate myocardial fibrosis by activating PI3K/Akt and inhibiting P38 mitogen-activated protein kinase (P38 MAPK). Studies have shown that in the chicken embryo chorioallantoic membrane model, angelica sinensis and ligustrum Chuanwei in the treatment of ischemic heart disease can increase the expression of VEGF in ischemic heart tissue of rats, stimulate endothelial cell proliferation, and increase blood vessel density.

Micrornas (mirnas) play a key role in regulating gene expression, mainly by blocking the translation of target mRNA or inducing mRNA degradation. Mirnas also play an important role in angiogenesis and cardiovascular disease. One study found that QSYQ promotes angiogenesis by targeting mir-223p, one of the key mirnas that regulate angiogenesis in microvascular endothelial cells without blood supply. QSYQ significantly increases the expression of HIF-1α, VEGF, MAPK, PI3K and AKT in hypoxia-inducing factor 1α (HIF-1α) signaling pathway. Other studies have shown that components of QSYQ promote angiogenesis by activating the PI3K/Akt pathway and up-regulating the expression of HIF-1α and VEGF. It is worth noting that some herbs have anti-angiogenic effects and have been used to treat cancer and decompensated heart failure.