Spontaneous hypertensive rats (SHRs) are considered to be an inherited strain of hypertension that is similar in many ways to people with essential hypertension. 1 The development of cardiac fibrosis and subsequent diastolic and systolic dysfunction are major complications of hypertensive heart disease. It leads to the gradual destruction of normal heart structure, which increases the risk of adverse cardiac events such as myocardial ischemia, infarction, arrhythmia, and sudden cardiac death. Therefore, the prevention and/or reversal of cardiac fibrosis is extremely important in the treatment of hypertensive heart disease.
Angiotensin (Ang) II plays a crucial role in heart remodeling. It is produced by angiotensin-converting enzyme (ACE). However, there is a heart-specific alternative pathway for the production of Ang II that is activated by chymotrypsin. Chymotrypsin is stored in mast cells as a chymotrypsin-like serine protease. 7,8 In patients with heart failure, cardiac mast cell density is significantly increased and chymotrypsin may play a role in the development of several cardiovascular remodeling effects. 9 Cardiac chymotrypsin appears to promote cardiac remodeling by forming Ang II with proliferative properties. 10 In fact, these adverse events do not occur in rodents with mast cell deficiency, nor do they occur in cases where cardiac mast cells are prevented from degranulating by drugs.
Since ancient times, the Chinese have demonstrated the safety and effectiveness of using herbs to treat cardiac fibrosis and heart failure. Dozens of Chinese herbal formulations have been used to treat heart failure. 13 Qili Qiangxin is a special Chinese medicine developed on the basis of meridian theory. With the advancement of modern technology, more and more herbal compound extracts have been certified, standardized and successfully used in modern clinical practice. Qili Qiangxin Capsules was developed 20 years ago and registered by China's State Food and Drug Administration in 1996 for the treatment of heart failure. The active ingredients of QLQX include Chinese herbs such as Astragli, ginseng, Fuzi, salviorrhiza miltiorrhiza, pepper seed, Purpurea, polygonum multiflorum, cassia twigs, safflower, fragrant peel and orange peel. Asligan is the main active pharmacological ingredient.
