Medicinal Plant Research 2025, Vol.15, No.5, 233-243 http://hortherbpublisher.com/index.php/mpr 233 Research Article Open Access Protective Mechanisms of Salvia miltiorrhiza Extracts in Ischemic Heart Disease Models JieHuang 1, Chuchu Liu 2 1 Tropical Medicinal Plant Research Center, Hainan Institute of Tropical Agricultural Resources, Sanya, 572025, Hainan, China 2 Institute of Life Science, Jiyang College of Zhejiang A&F University, Zhuji, 311800, Zhejiang, China Corresponding author: chuchu.liu@jicat.org Medicinal Plant Research, 2025, Vol.15, No.5 doi: 10.5376/mpr.2025.15.0025 Received: 20 Aug., 2025 Accepted: 25 Sep., 2025 Published: 26 Oct., 2025 Copyright © 2025 Huang and Liu, This is an open access article published under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Preferred citation for this article: Huang J., and Liu C.C., 2025, Protective mechanisms of Salvia miltiorrhiza extracts in ischemic heart disease models, Medicinal Plant Research, 15(5): 233-243 (doi: 10.5376/mpr.2025.15.0025) Abstract Ischemic heart disease (IHD), is one of the diseases with the highest mortality rate worldwide. Its pathogenesis includes oxidative stress, inflammatory response, apoptosis and myocardial remodeling, etc. S. miltiorrhiza, as a traditional Chinese medicine, has long been used to treat cardiovascular diseases. This study explored the multi-target protective mechanism of S. miltiorrhiza extract in the IHD experimental model. It demonstrated that, the lipophilic components, like tanshinone, and water-soluble components (such as salvianolic acid) in S. miltiorrhiza work in synergy in terms of antioxidation, anti-inflammation, anti-apoptosis, and promoting angiogenesis. Its action pathways include signaling pathways, like PI3K/Akt, Nrf2/HO-1, MAPK and TLR4/NF-κB, which can alleviate myocardial ischemia/reperfusion injury, improve cardiac function and inhibit myocardial fibrosis. Animal and cell experiments, further verified its mechanism of action in regulating metabolic pathways, promoting endothelial protection and improving hemodynamics. The results of previous studies are positive, but more clinical trials are needed to confirm them. This study provides a theoretical basis and experimental evidence for the modern pharmacological development of S. miltiorrhiza, and the treatment of ischemic heart disease. Keywords Salvia miltiorrhiza extract; Ischemic heart disease; Antioxidant; Multi-target mechanism; Signal pathway; Myocardial protection 1 Introduction Ischemic heart disease (IHD), has a relatively high incidence and mortality rate worldwide, accounting for nearly one-third of global deaths. Coronary heart disease, as the most common type of IHD, accounts for approximately 40% of cardiovascular-related deaths. Its risk factors includes diabetes, hypertension, dyslipidemia, obesity and unhealthy lifestyles, which have led to an increasing incidence rate in both developed, and developing countries (Zhang et al., 2023). Myocardial ischemia (MI), is characterized by an imbalance between oxygen supply and demand in the myocardium, which in turn leads to damage and death of myocardial cells. The key pathological mechanisms include oxidative stress, inflammatory response, endothelial dysfunction, apoptosis and metabolic disorders. These factors jointly drive myocardial infarction, fibrosis and poor cardiac remodeling (Zhou et al., 2012; Lin et al., 2021; Zhang et al., 2023). In traditional Chinese Medicine (TCM), Salvia miltiorrhiza (Danshen) has been used to treat cardiovascular diseases for hundreds of years, including angina pectoris, myocardial infarction and heart failure. Its root extract is renowned for promoting blood circulation, and removing blood stasis, improving blood circulation and relieving chest pain (Zhang et al., 2023; Shan et al., 2024). Modern pharmacological research has found that, the active ingredients contained in S. miltiorrhiza, like tanshinone and tanshinic acid, have antioxidant, anti-inflammatory, endothelial protective, anti-apoptotic and anti-fibrotic effects. Experimental and clinical studies have further demonstrated that, Salvia miltiorrhiza extract can reduce infarction area, improve cardiac function, regulate metabolism and inflammatory pathways, and has a protective effect on myocardial ischemia-reperfusion injury (Ren et al., 2019; Lin et al., 2021; Shan et al., 2024; Li et al., 2025). These effects are achieved through multi-target mechanisms, such as regulating oxidative stress, lipid metabolism,
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