Abstract
Objective:
Ischemic heart failure (IHF) is a multifaceted syndrome associated with significant mortality and high hospitalization rates globally. Yiqi Huoxue prescription (YQHX) has been incorporated into clinical practice, showing significant therapeutic efficacy. However, to date, the pharmacological mechanisms remain vague. We combined multi-omics, machine learning, and molecular docking strategies to elucidate the mechanisms by which YQHX protects against IHF.
Methods:
Clinically, the efficacy and safety of YQHX in improving cardiac function in IHF patients were observed. Transcriptomic, proteomic, and targeted metabolomic analyses were performed on serum samples from IHF patients and healthy individuals before and after YQHX intervention. Multi-omics association analysis integrating machine learning identified the potential mechanisms underlying YQHX's effects. Key ingredient-targets interactions were validated in vitro experiments.
Results:
After 12 weeks of treatment, YQHX significantly decreased N-terminal pro-B-type natriuretic peptide (NT-proBNP) (MD, -1180.28; 95% CI: -2107.23 to -253.32), enhanced left ventricular ejection fraction (LVEF) (MD, 4.78; 95% CI: 2.23 to 7.32), and improved 6-minute walk distance (6MWD). No serious adverse events were observed during the study. Multi-omics integration analysis revealed that platelet activation NET formation, HIF-1 signaling pathway, TCA cycle, and glycolysis are indispensable pathways for the treatment of IHF. Machine learning has identified H3-3A, HMGB1, SOD2, ACTG1, PGAM1, FGA, LDHA, FN1, VWF, and ACO2 as critical molecular targets of YQHX treatment. Clinical research further demonstrated that YQHX treatment beneficially modulates energy metabolism, improves coagulation system functions, and ameliorates inflammatory responses in IHF. Molecular docking revealed that astragaloside I/III/IV, isoastragaloside I/II, paeoniflorin, and hydroxysafflor yellow A are likely active compounds contributing to YQHX's therapeutic effects, and these findings were further validated through in vitro experiments.
Conclusion:
YQHX combats IHF via multi-target and multi-pathway mechanisms, including energy metabolism reprogramming, coagulation system enhancement, and immune-inflammatory response modulation, positioning it as a potential therapeutic strategy for IHF.
Keywords:
Yiqi Huoxue; ischemic heart failure; machine learning; molecular docking; multi-omics; traditional Chinese medicine.