Chulalongkorn Medical Journal


Cardiac glycosides (CGs), such as digoxin, were one of the earliest pharmacological treatments used clinicallyin the management of heart failure. Plants from the Apocynaceae family which grow indigenously in Asiaespecially in the tropical and subtropical regions and one of the largest plant families, are producers of CGs.The purpose of this review is to update the research progress of CGs with cardiotonic effects obtained fromApocynaceae family on heart failure. Heart failure increases morbidity and mortality globally. It is manifested bycompromised contractility of the heart to pump adequate blood and oxygen to all other parts of the body. CGsbind to Na+/K+-ATPase and inhibit the sodium pump, which is believed the major mechanism of action thatcontributes to its cardiotonic properties. The mechanisms of action of various CGs, particularly the cardenolidespresent in Apocynaceae plants are discussed in this article. Besides digoxin, other CGs have the potential to bedeveloped as an alternative or adjunct therapy for the management of heart failure.


Faculty of Medicine, Chulalongkorn University

First Page


Last Page