Evaluation of the Efficacy of Crataegus oxyacantha in Dogs with Early-Stage Heart Failure
Background Myxomatous mitral valve disease (MMVD) is the most common cardiopathy in middle-aged dogs. When the dog is asymptomatic and has an enlarged left atrium, treatment is beneficial; however, some allopathic drugs are very costly and may produce side effects. To extend the duration of this asymptomatic phase, complementary therapies such as herbal medicine and homeopathy are available. Although herbal therapy with extract of Crataegus oxyacantha is beneficial, there is a risk of adverse reactions—unlike with homeopathy, where the risk is minimized with the administration of ultra-diluted doses.
Objective This study evaluated the efficacy of Crataegus oxyacantha, as mother tincture (MT) and in 6 cH homeopathic formulation, in treating the initial phase of heart failure due to MMVD in a veterinary clinic setting.
Methods A total of 30 dogs with MMVD, 7 years or older and weighing up to 10 kg, were randomized into three groups as follows: Crataegus 6 cH, Crataegus MT, and hydroalcoholic solution (placebo). Animals were evaluated through echocardiography parameters, laboratory blood tests, and systolic blood pressure (SBP) measurements at 30, 60, 90, and 120 days after initiation of therapy, for statistical analysis and monitoring of the blinded study.
Results Patients who received Crataegus 6 cH showed a reduction in SBP 60 days after treatment, while those receiving Crataegus MT exhibited a reduction 90 days after the therapy was initiated. There was a significant linear regression when evaluating the effect of treatment with Crataegus 6 cH on SBP measurements over the evaluation intervals (linear equation: SBP = 176.57 mm Hg – 0.21x, where x represents days of treatment). There was an increase in both fractional shortening and isovolumetric relaxation time for those patients receiving the homeopathic formulation.
Conclusions Therapy with Crataegus was beneficial for hypertensive and cardiopathic dogs with MMVD, extending the duration of the asymptomatic phase. The reduction in SBP occurred more swiftly in the 6 cH group than in the MT-treated dogs.
• The study is the first to use Crataegus (6cH and mother tincture) in dogs with myxomatous mitral valve disease (MMVD).
• The study design was randomized, blinded, and placebo-controlled to evaluate efficacy.
• Data analysis included comparison between effects of treatment using homeopathy and mother tincture.
• The results suggest that homeopathic Crataegus is beneficial for hypertensive and cardiopathic dogs with MMVD.
Received: 19 November 2019
Accepted: 26 February 2020
17 July 2020 (online)
The Faculty of Homeopathy
- 1 Buchanan JW. Chronic valvular disease (endocardiosis) in dogs. Adv Vet Sci Comp Med 1977; 21: 75-106
- 2 Borgarelli M, Zini E, D'Agnolo G. et al. Comparison of primary mitral valve disease in German Shepherd dogs and in small breeds. J Vet Cardiol 2004; 6: 27-34
- 3 Jung SW, Sun W, Griffiths LG, Kittleson MD. Atrial fibrillation as a prognostic indicator in medium to large sized dogs with myxomatous mitral valvular degeneration and congestive heart failure. J Vet Intern Med 2016; 30: 51-57
- 4 Chamas PPC, Saldanha IRR, Costa RLO. et al. Prevalência da doença degenerativa valvar crônica mitral em cães. J Health Sci Inst 2011; 29: 214-217
- 5 Borgarelli M, Buchanan JW. Historical review, epidemiology and natural history of degenerative mitral valve disease. J Vet Cardiol 2012; 14: 93-101
- 6 Gordon SG, Saunders AB, Wesselowski SR. Asymptomatic canine degenerative valve disease: current and future therapies. Vet Clin North Am Small Anim Pract 2017; 47: 955-975
- 7 Keene BW, Atkins CE, Bonagura JD. et al. ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs. J Vet Intern Med 2019; 33: 1127-1140
- 8 Misbach C, Gouni V, Tissier R. et al. Echocardiographic and tissue Doppler imaging alterations associated with spontaneous canine systemic hypertension. J Vet Intern Med 2011; 25: 1025-1035
- 9 Waldrop JE, Stoneham AE, Tidwell AS, Jakowski RM, Rozanski EA, Rush JE. Aortic dissection associated with aortic aneurysms and posterior paresis in a dog. J Vet Intern Med 2003; 17: 223-229
- 10 Rondeau DA, Mackalonis ME, Hess RS. Effect of body position on indirect measurement of systolic arterial blood pressure in dogs. J Am Vet Med Assoc 2013; 242: 1523-1527
- 11 Steagall Gomes DL, Romanholi LM, de Souza MT. A fitoterapia e a homeopatia como práticas médicas alternativas. Rev Bras Enferm 1985; 38: 329-348
- 12 Wang J, Xiong X, Feng B. Effect of Crataegus usage in cardiovascular disease prevention: an evidence-based approach. Evid Based Complement Alternat Med 2013; 2013: 149363
- 13 de Quadros APO, Mazzeo DEC, Marin-Morales MA, Perazzo FF, Rosa PCP, Maistro EL. Fruit extract of the medicinal plant Crataegus oxyacantha exerts genotoxic and mutagenic effects in cultured cells. J Toxicol Environ Health A 2017; 80: 161-170
- 14 Nascimento DF, Santana ANM, Leite IO. et al. Estudo de toxicologia clínica de um fitoterápico contendo Passiflora incarnata L., Crataegus oxyacantha L., Salix alba L. em voluntários saudáveis. Rev Bras Farmacogn 2009; 19: 261-268
- 15 Shatoor AS, Soliman H, Al-Hashem F, Gamal BE, Othman A, El-Menshawy N. Effect of hawthorn (Crataegus aronia syn. Azarolus (L)) on platelet function in albino Wistar rats. Thromb Res 2012; 130: 75-80
- 16 Verma SK, Jain V, Verma D. et al. Crataegus oxyacantha – a cardioprotective herb. J Herb Med Toxic 2007; 1: 65-71
- 17 Lacaille-Dubois MA, Franck U, Wagner H. Search for potential angiotensin converting enzyme (ACE)-inhibitors from plants. Phytomedicine 2001; 8: 47-52
- 18 Pedersen HD, Häggström J. Mitral valve prolapse in the dog: a model of mitral valve prolapse in man. Cardiovasc Res 2000; 47: 234-243
- 19 Haydari MR, Panjeshahin MR, Mashghoolozekr E, Nekooeian AA. Antihypertensive effects of hydroalcoholic extract of Crataegus Azarolus Subspecies Aronia fruit in the rats with renovascular hypertension: an experimental mechanistic study. Iran J Med Sci 2017; 42: 266-274
- 20 Kim SH, Kang KW, Kim KW, Kim ND. Procyanidins in crataegus extract evoke endothelium-dependent vasorelaxation in rat aorta. Life Sci 2000; 67: 121-131
- 21 Abdul-Ghani AS, Amin R, Suleiman MS. Hypotensive effect of Crataegus oxyacantha . Int J Crude Drug Res 1987; 25: 215-220
- 22 Shatoor AS. In vivo hemodynamic and electrocardiographic changes following Crataegus aronia syn. Azarolus L administration to normotensive Wistar rats. Saudi Med J 2013; 34: 123-134
- 23 Finco DR. Association of systemic hypertension with renal injury in dogs with induced renal failure. J Vet Intern Med 2004; 18: 289-294
- 24 Sansom J, Rogers K, Wood JL. Blood pressure assessment in healthy cats and cats with hypertensive retinopathy. Am J Vet Res 2004; 65: 245-252
- 25 Carlos Sampedrano C, Chetboul V, Gouni V, Nicolle AP, Pouchelon JL, Tissier R. Systolic and diastolic myocardial dysfunction in cats with hypertrophic cardiomyopathy or systemic hypertension. J Vet Intern Med 2006; 20: 1106-1115
- 26 Kamakura ON, Goldfeder GT, Itikawa PH. et al. Comparative evaluation of the echocardiographic parameters of dogs with chronic mitral valve regurgitation treated with amlodipine or pimobendan. Acta Sci Vet 2017; 45: 1-6
- 27 Chetboul V, Lefebvre HP, Sampedrano CC. et al. Comparative adverse cardiac effects of pimobendan and benazepril monotherapy in dogs with mild degenerative mitral valve disease: a prospective, controlled, blinded, and randomized study. J Vet Intern Med 2007; 21: 742-753
- 28 Schwinger RH, Pietsch M, Frank K, Brixius K. Crataegus special extract WS 1442 increases force of contraction in human myocardium cAMP-independently. J Cardiovasc Pharmacol 2000; 35: 700-707
- 29 Ammon H, Kaul R. Heart circulation mechanism of action of Crataegus extract, flavanoid and procyanidin. Part I. history and workings. Dtsch Apoth Ztg 1994; 134: 433-436
- 30 Daniele C, Mazzanti G, Pittler MH, Ernst E. Adverse-event profile of Crataegus spp.: a systematic review. Drug Saf 2006; 29: 523-535
- 31 Horoz M, Gok E, Genctoy G. et al. Crataegus orientalis associated multiorgan hypersensitivity reaction and acute renal failure. Intern Med 2008; 47: 2039-2042