Hello, fred27!
Aortic regurgitation can be an acute (sudden onset) or a chronic
condition (developing over many years). In either case, valve
replacement surgery is usually recommended only when valvular
insufficiency progresses to the point where physical symptoms become
evident In chronic regurgitation, symptoms make take years to develop.
In acute regurgitation, symptoms may appear suddenly without allowing
the heart to compensate or enlarge to take on the increased workload.
When the condition is as severe as your doctor has pronounced,
valve-replacement surgery is considered the only viable alternative.
** While there is some scientific evidence that Terminalia arjuna, the
major component in Arjuna cardiac tonic, can help in cardiovascular
circulation, there is no scientific evidence that "Arjuna cardiac
tonic", or other similar herbal compounds, can contribute to the
production of new, healthy, valvular tissue to replace that which is
damaged.
Ultimately, the decision to try an herbal remedy in lieu of surgery
will be up to you. Certainly, there are many legitimate reasons why
individuals question the decision to opt for major surgery. Age and
personal or ethical reasons can all contribute to a determination
about which course to take. However, it is extremely important that
you evaluate your consideration of an herbal product in light of the
severity of your condition. A physician's rating level of 1 or 2 in
severity is a very different scenario for trying an herbal product as
opposed to a time when your doctor has diagnosed your level of aortic
regurgitation at it's most severe.
So that you may make an informed decision, I am presenting what
information I have unearthed pertaining to the clinical usefulness of
Terminalia arjuna for cardiac health. I have also provided an overview
of Aortic Valve Regurgitation and Valve Replacement surgery in case
you would like to review all your options. (If you don't need further
information about the valve surgery, feel free to pass it on by...)
++++++++++++++++++++++++++++++++++++++++
OVERVIEW OF AORTIC VALVE REGURGITATION
++++++++++++++++++++++++++++++++++++++++
From "Aortic valve regurgitation." MayoClinic.com
http://www.cnn.com/HEALTH/library/DS/00419.html
"The aortic valve consists of three tightly fitting, triangular-shaped
flaps of tissues called leaflets. These leaflets connect to the aorta
through a ring called the annulus."
"Heart valves open like a one-way gate. The leaflets of the aortic
valve are forced open as the left ventricle contracts and blood flows
into the aorta. When all of the blood has gone through the valve and
the left ventricle has relaxed, the leaflets swing closed to prevent
the blood that has just passed into the aorta from flowing back into
the left ventricle."
"A defective heart valve is one that fails either to open or close
fully. When a valve doesn't close tightly, blood can leak backward.
This backward flow through a valve is called regurgitation."
"Aortic regurgitation - of any cause - can weaken your heart. In
aortic regurgitation, blood leaks back into the left ventricle instead
of flowing onward to the rest of your body after being pumped into the
aorta. This forces the left ventricle to hold more blood. In response,
this chamber of your heart may enlarge and thicken. At first these
adaptations help the left ventricle pump blood with more force. But
eventually these changes weaken the left ventricle - and your heart
overall."
==
From "Aortic Regurgitation." CaroMont Health.
http://www.caromont.org/11640.cfm
"In acute aortic regurgitation, symptoms come on quickly since the
heart has not had the time to compensate or enlarge. In chronic aortic
regurgitation, symptoms develop more gradually and may not be noticed
for years until the condition worsens."
"In both cases, symptoms may include:
Shortness of breath
Fatigue, especially after physical activity
Fluid retention in certain parts of the body, such as the ankles
Heart arrhythmias (abnormal heart beats)
Angina (chest pain from insufficient blood supply)
Hypotension (low blood pressure)
==
From another article on "Aortic Regurgitation" from Health Central
http://www.drugs.com/data/channel/md/healthcentral.cfm?file=nd0160G.htm&ID=160&type=GI
What happens when blood leaks backwards into the ventricle from the aorta?
"Not enough blood is getting out to the body as blood leaks backward
from the aorta into the ventricle. This makes the heart pump harder to
try to push more blood out of the heart with each heartbeat. Because
the heart is working so hard it starts to get bigger. With time the
left ventricle gets so big it cannot pump very well. Less blood is
pumped to the muscles of the heart and out to the body. This causes
you to have chest pain or to be short of breath."
"As time passes, your heart disease can get worse and cause more
problems. Many people with aortic regurgitation also have ventricular
tachycardia (tak-uh-kar-d-uh) or fibrillation (fib-rih-la-shun). This
is when the ventricles beat too fast or quiver instead of pumping. You
can have a heart attack when the heart is not getting enough blood and
having abnormal heartbeats. With time, the heart may stop completely."
==
Another very informative article may be found on WebMd:
"Aortic Valve Regurgitation." WebMD Health (scroll through all pages)
http://my.webmd.com/hw/heart_disease/hw179694.asp
+++++++++++++++++
TEMRINALIA ARGUNA
+++++++++++++++++
Teminalia Arguna is the primary herb in Arjuna Cardiac Tonic. The
herb is used quite often in Ayurvedic medicine for cardiac health.
Read "VEDIC WAY TO THE HEART," by Isidore Domnick Mendis. the
South-Asian.com (2001)
http://www.the-south-asian.com/June2001/Heart_and_Ayurveda.htm
=
From the Herbal Provider Website:
http://www.herbal-provider.com/arjuna.html
"Arjuna or Terminalia arjuna is a unique herb that helps maintain a
healthy heart and reduces the effects of stress and nervousness.
Arjuna promotes effective cardiac functioning and regulates blood
pressure. Arjuna has been the herb of choice in Ayurveda for
cardiovascular health. Arjuna's ability to suppress the blood's
absorption of lipids indicates that it has cholesterol-regulating
properties. Its principle constituents are §-sitosterol, ellagic acid
and arjunic acid."
"The bark of Arjuna is useful as an anti-ischemic and cardioprotective
agent in hypertension and in ischemic heart disease, especially in
disturbed cardiac rhythm, angina or myocardial infarction. The bark
powder possesses diuretic and a general tonic effect in cases of
cirrhosis of the liver, in addition to prostaglandin enhancing and
coronary risk factor modulating properties. It induces a
drug-dependent decrease in blood pressure and heart rate."
"Recent studies have investigated the mechanism of this activity and
have shown a dose-dependent regulation of blood pressure and heart
rate. There was also a slight increase in the HDL-to-total cholesterol
ratio and an overall improvement in the cardiovascular profile. The
bark of Arjuna inhibits the oxidation of LDL and accelerates the
turnover of LDL-cholesterol in liver. This enhances the elimination of
cholesterol from the body. The suppression of hepatic cholesterol
biosynthesis by Terminalia arjuna is the mechanism responsible for a
significant lowering of beta-lipoprotein lipids and the recovery of
HDL components in hyperlipidemia. In a study on the efficacy of the
bark powder in treating congestive cardiac failure (CCF), over 40% of
the cases showed marked improvement. CCF due to congenital anomaly of
heart and valve disease was also brought under control. 4 out of 9
cases of CCF due to chronic bronchitis were also relieved by the
treatment. Arjuna is also known to relieve symptomatic complaints of
essential hypertension viz. giddiness, insomnia, lassitude, headache
and the inability to concentrate. Oral administration of an aqueous
suspension of the bark powder reduces coagulation, bleeding and
prothrombin time."
***
Please note that while the above scientific notation sounds very
promising, there are no footnotes on the website referencing these
specific studies!
***
A similar product to Arjuna Cardiac Tonic, called "Heart Strong," may
be found on the Ayurveda Herbs website.
http://www.ayurveda-herbs.com/4.htm
There are a host of conditions highlighted for which this herb may be
useful. Notice the disclaimer, however:
"Heart strong is made from ARJUNA (Terminalia Arjuna bark) plus 11
rejuvenative, tonic, stimulant and blood purifying ayurveda herbs in a
base of Honey and Herbal ghee (Herbal Clarified butter which is
cholesterol free).
"Arjuna Rasayana has been traditionally designed from Ayurvedic
Herbalism for the following. (See list of conditions, including
various heart and circulatory problems.)
(NOTE THE DISCLAIMER) **** No clinical proof has been documented. This
product should be taken based upon your faith and knowledge of
Ayurveda.
==
If you are seriously considering the use of Ayurvedic herbs, I
recommend seeking out an opinion from a well-respected cardiologist
who is open to alternative therapies. It is important to note,
however, that Ayurveda is not recognized as a medical discipline in
the United States and is not regulated by licensure. It might be very
difficult to find a cardiologist oriented in western medicine who is
open to discussing such therapies.
You might be interested in the following article:
"Ayurveda for the Heart," by Shubhra Krishan. Healthy & Natural
Journal, Dec, 2000.
http://www.findarticles.com/p/articles/mi_m0HKL/is_6_7/ai_76471217
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
SCIENTIFIC ABSTRACTS CONCERNING TEMINALIA ARGUNA IN RELATION TO HEART HEALTH
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
The following abstracts concern the positive effects of Terminalia
arguna in various aspects of heart and cardiovascular health. None are
particular to Aortic Valve regurgitation, however.
://www.google.com/search?hl=en&lr=&q=Terminalia+arjuna+
"Beneficial effects of Terminalia arjuna in coronary artery disease."
Dwivedi S, Jauhari R. Indian Heart J. 1997 Sep-Oct;49(5):507-10.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9505018&dopt=Abstract
"Effect of Terminalia arjuna on angina pectoris, congestive heart
failure and left ventricular mass was studied in patients of
myocardial infarction with angina and/or ischaemic cardiomyopathy.
Bark stem powder of T. arjuna, 500 mg 8 hourly was administered to 10
patients of postmyocardial infarction angina and two patients of
ischaemic cardiomyopathy, in a dose of 500 mg 8 hourly
postoperatively, for a period of three months (Group A). These
patients were also on conventional treatment comprising of nitrates,
aspirin and/or calcium channel blockers. Twelve age-, sex-, body mass
index- and ECG-matched patients of postmyocardial infarction angina
receiving only conventional treatment served as controls (Group B).
Significant reduction in anginal frequency was noted in both groups
(3.5 +/- 1.98 to 1.08 + 1.08 per day vs 3.10 + 0.72 to 1.17 + 0.84 per
day). However, only Group A patients showed significant improvement in
left ventricular ejection fraction (42.25 + 9.96 to 52.67 + 12.32% vs
51.83 + 5.99 to 49.83 + 2.52%) and reduction in left ventricular mass
(159.18 + 51.11 to 127.47 + 52.40 gm/m2 vs 159.11 + 38.92 to 160.78 +
54.23 gm/m2) on echocardiography following three months of therapy.
Both patients with ischaemic cardiomyopathy showed significant
symptomatic relief in coronary heart failure from NYHA class III to
NYHA class I. Prolonged administration of T. arjuna did not show any
adverse effects on renal, hepatic and haematological parameters. The
potential of T. arjuna to improve left ventricular ejection fraction
and reduce left ventricular mass in coronary artery disease needs to
be harnessed."
==
A study concerning males with stable angina:
"Efficacy of Terminalia arjuna in chronic stable angina: a
double-blind, placebo-controlled, crossover study comparing Terminalia
arjuna with isosorbide mononitrate." - Abstract - Alternative Medicine
Review, August, 2002 by A Bharani, A Ganguli, LK Mathur.
http://www.findarticles.com/p/articles/mi_m0FDN/is_4_7/ai_91155410
"CONCLUSIONS: Terminalia arjuna bark extract, 500 mg 8 hourly, given
to patients with stable angina with provocable ischemia on treadmill
exercise, led to improvement in clinical and treadmill exercise
parameters as compared to placebo therapy. These benefits were similar
to those observed with isosorbide mononitrate (40 mg/day) therapy and
the extract was well tolerated. Limitations of this study include
applicability of the results to only men with chronic stable angina
but not necessarily to women, as they were not studied."
==
"Antianginal and cardioprotective effects of Terminalia arjuna, an
indigenous drug, in coronary artery disease." Dwivedi S, Agarwal MP. J
Assoc Physicians India. 1994 Apr;42(4):287-9.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7741874&dopt=Abstract
"The effect of bark powder of Terminalia arjuna, an indigenous drug,
on anginal frequency, blood pressure, body mass index, blood sugar,
cholesterol and HDL-cholesterol was studied in 15 stable (Group A) and
5 unstable (Group B) angina patients before and 3 months after T.
arjuna therapy. Tread mill test (TMT) and echocardiographic left
ventricular ejection fraction was evaluated in some cases. There was
50% reduction in anginal episodes in Group A cases (P < 0.01). TMT
performance improved from moderate to mild changes in 5 patients and
one with mild changes became negative for ischemia. The time to the
onset of angina and appearance of ST-T changes on TMT after T. arjuna
was delayed significantly. However, in patients with unstable angina
there was an insignificant reduction in anginal frequency. These
patients also needed diltiazem, B-blockers and nitroglycerine in
addition to T. arjuna. The drug lowered systolic blood pressure and
body mass index to a significant level (p < 0.05) and increased
HDL-cholesterol only slightly along with marginal improvement in left
ventricular ejection fraction in stable angina patients. There were no
deleterious effects on liver or kidney functions. Our results suggest
that monotherapy with T. arjuna is fairly effective in patients with
symptoms of stable angina pectoris. However, it has a limited role in
unstable angina."
==
"Botanical influences on cardiovascular disease." Miller AL. Altern
Med Rev. 1998 Dec;3(6):422-31.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9855567&dopt=Abstract
"Several botanicals, including Crataegus oxycantha, Terminalia arjuna,
Inula racemosa, and Astragalus membranaceus, have been found to have
therapeutic benefit for the treatment of cardiovascular disease.
Crataegus oxycantha has been used traditionally as a cardiac tonic and
current uses include treatment for angina, hypertension, arrhythmias,
and congestive heart failure. ... The bark of the Terminalia arjuna
tree has a long history of use as a cardiac tonic as well, and has
been indicated in the treatment of coronary artery disease, heart
failure, hypercholesterolemia and for relief of anginal pain.
Additionally, it has been found to have antibacterial and
antimutagenic properties. Inula racemosa, also known as Pushkarmoola,
is another traditional Ayurvedic botanical that has potential
cardioprotective benefit. In human trials, a combination of Inula
racemosa and Commiphora mukul was shown to be superior to
nitroglycerin in reducing the chest pain and dyspnea associated with
angina. Astragalus membranaceus, a Chinese herb, is often used as a
"Qi tonifier" and has been studied for its therapeutic benefit in
treatment of ischemic heart disease, myocardial infarction, heart
failure, and relief of anginal pain. Clinical studies have indicated
that its in vitro antioxidant activity is the mechanism by which it
affords its cardioprotective benefit."
==
"Safety and efficacy of Hartone in stable angina pectoris--an open
comparative trial."
Kumar PU, Adhikari P, Pereira P, Bhat P. J Assoc Physicians India 1999
Jul; 47(7): 685-9.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10778587
OBJECTIVES: "To evaluate the safety and efficacy of 'Hartone'--a
proprietary herbal product primarily containing Terminalia arjuna in
stable angina pectoris patients. PATIENTS AND METHODS: Ten patients
with stable angina pectoris were given Hartone 2 caps twice daily for
6 weeks and 1 cap twice daily for the next 6 weeks. Haematological and
biochemical investigations to assess safety were carried out on day 0,
day 42 and day 84. Serum lipid profile was done before and after
therapy. Efficacy was assessed by considering the reduction in the
number of anginal episodes and improvement in stress test. The results
were compared with 10 patients of stable angina pectoris on isosorbide
mononitrate (ISMN) 20 mg twice daily. RESULTS: Hartone afforded
symptomatic relief in 80% of patients and ISMN in 70%. The number of
anginal attacks were reduced from 79/wk to 24/wk by Hartone and from
26/wk to 7/wk by ISMN. Although patients of both groups showed
improvement in several stress test parameters compared to base line,
the difference was not statistically significant. Hartone improved BP
response to stress test in two patients and ejection fraction in one.
Hartone was better tolerated than ISMN and showed no evidence of
hepatic or renal impairment. Its effects on lipid profile was not
consistent. CONCLUSION: Hartone is a safe and effective anti-anginal
agent comparable to ISMN and is better tolerated. Large scale,
randomised, double blind trials are needed to prove its efficacy."
===
"Salutary effect of Terminalia Arjuna in patients with severe
refractory heart failure." Bharani A, Ganguly A, Bhargava KD. Int J
Cardiol 1995 May; 49(3): 191-97.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=7649665
"Twelve patients with refractory chronic congestive heart failure
(Class IV NYHA), related to idiopathic dilated cardiomyopathy (10
patients); previous myocardial infarction (one patient) and peripartum
cardiomyopathy (one patient), received Terminalia Arjuna, an Indian
medicinal plant, as bark extract (500 mg 8-hourly) or matching placebo
for 2 weeks each, separated by 2 weeks washout period, in a double
blind cross over design as an adjuvent to maximally tolerable
conventional therapy (Phase I). The clinical, laboratory and
echocardiographic evaluation was carried out at baseline and at the
end of Terminalia Arjuna and placebo therapy and results were
compared. Terminalia Arjuna, compared to placebo, was associated with
improvement in symptoms and signs of heart failure, improvement in
NYHA Class (Class III vs. Class IV), decrease in echo-left ventricular
enddiastolic (125.28 +/- 27.91 vs. 134.56 +/- 29.71 ml/m2; P < 0.005)
and endsystolic volume (81.06 +/- 24.60 vs. 94.10 +/- 26.42 ml/m2; P <
0.005) indices, increase in left ventricular stroke volume index
(44.21 +/- 11.92 vs. 40.45 +/- 11.56 ml/m2; P < 0.05) and increase in
left ventricular ejection fractions (35.33 +/- 7.85 vs. 30.24 +/-
7.13%; P < 0.005)."
"On long term evaluation in an open design (Phase II), wherein Phase I
participants continued Terminalia Arjuna in fixed dosage (500 mg
8-hourly) in addition to flexible diuretic, vasodilator and digitalis
dosage for 20-28 months (mean 24 months) on outpatient basis, patients
showed continued improvement in symptoms, signs, effort tolerance and
NYHA Class, with improvement in quality of life."
==
"Antioxidant and hypocholesterolaemic effects of Terminalia arjuna
tree-bark powder: a randomised placebo-controlled trial." Gupta R,
Singhal S, Goyle A, Sharma VN
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11225136
OBJECTIVE: "To evaluate the antioxidant and hypocholesterolaemic
effects of Terminalia arjuna tree bark (a popular cardiotonic
substance in Indian pharmacopoeia) and to compare it with a known
antioxidant, vitamin E, we performed a randomized controlled trial."
(Read further...)
==
Another abstract regarding Terminalia Arjuna in relation to smoking:
"Terminalia Arjuna Reverses Impaired Endothelial Function in Chronic
Smokers." Anil Bharani, Lalit Kumar Ahirwar, Neeraj Jain
http://indianheartjournal.com/MarchApril2004/Terminalia%20Arjuna%20Reverses%20Impaired%20Endothelial/terminalia_arjuna_reverses_impai.htm
**************
SUPPORT FORUM
**************
The Forum on the Valve Replacement.com website is a great place to
visit and talk over your concerns with others who undergone, or are
considering, valve replacement surgery.
Forum
http://www.valvereplacement.com/forums/index.php
Stories
http://www.valvereplacement.com/
==
I understand that heart surgery can be a frightening prospect since
the outcome is never a surety. But heck.....if you've ever signed the
release for having a wisdom tooth extracted, the potential
consequences can be nearly as frightening! In the hands of a good,
experienced heart surgeon, the end result of aortic valve replacement
can mean many more years of enjoyable, good quality life. My father
had an aortic valve replacement when he was 70 years old. The doctor
recommended a porcine valve. Today, at age 85, he likes to joke that
his newest "kin" must have been a very exceptional pig. The doctor has
detected not a single leak in 14 years! I am very thankful that I have
had my dad around for so many years, and proud that he opted for the
surgery despite his nervousness about such a major procedure.
Should you decide on surgery, I have good faith that the outcome will
be successful! In either case, I wish you the very best of luck in
whatever decision is right for you.
Sincerely,
umiat
Google Search Terms
aortic valve regurgitation
Terminalia arjuna
Terminalia arjuna AND heart valve
Terminalia arjuna AND heart valve replacement
cardiac tonic
alternatives to heart valve replacement
alternatives to aortic valve replacement
holistic treatment for heart valve replacement
homeopathic alternatives to aortic valve replacement
can herbal medicine heal aortic valve?
how successful is aortic valve replacement?
ayurvedic cardiologist +US
various searches on PubMed |
