The management of severe hemorrhagic shock requires rapid resuscitation to restore organ perfusion. Hemoglobin-based oxygen carriers (HBOCs) like HBOC-CHP01 provide an essential alternative to blood. Unfortunately, these carriers often cause acute heart damage during the recovery phase. A new study investigates the protective effect of Salvia Miltiorrhiza myocardial injury prevention strategies using SMI. Overall, this research highlights SMI's potential as a safe adjunctive therapy during critical care.

Network pharmacology initially predicted the complex mechanisms of Salvia Miltiorrhiza Injection (SMI). Researchers identified 189 potential targets within the heart tissue. Core candidates included AKT1, CASP3, and HIF-1α. These molecules play vital roles in cellular stress and survival. Specifically, SMI appears to target pathways that regulate oxidative stress and programmed cell death.

Cardioprotection Against Salvia Miltiorrhiza Myocardial Injury

In rat models, SMI showed remarkable results during shock resuscitation. Researchers treated rats with HBOC-CHP01 alone or combined with SMI. While survival rates remained similar over 72 hours, the physiological benefits were clear. SMI significantly reduced plasma markers of heart damage, including AST, LDH, and cardiac Troponin I. Furthermore, histological analysis confirmed reduced inflammation and apoptosis in myocardial tissues.

The primary mechanism involves the Nrf2/HO-1 antioxidant pathway. SMI treatment notably upregulated myocardial Nrf2 and HO-1 expression. Consequently, this activation lowered reactive oxygen species and myeloperoxidase levels. By strengthening the heart's internal defense, SMI mitigates the oxidative stress typically caused by oxygen carriers. Primarily, this suggests SMI could improve the clinical safety of HBOCs in emergency medicine.

How does Salvia Miltiorrhiza Injection reduce heart damage during shock?

SMI activates the Nrf2/HO-1 antioxidant pathway. This process reduces reactive oxygen species and inflammation, which protects cardiomyocytes from the stress of resuscitation.

What cardiac markers does SMI help lower?

Studies show SMI significantly decreases plasma markers such as AST, LDH, Creatine Kinase (CK), and cardiac Troponin I (cTnI) after resuscitation from shock.

Disclaimer: This content is for informational and educational purposes only. It does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Refer to the latest local and national guidelines for clinical practice.

References

Hao S et al. Protective effect of Salvia Miltiorrhiza Injection on myocardial injury in rats with haemorrhagic shock resuscitated by HBOC-CHP01. Artif Cells Nanomed Biotechnol. 2026 Dec undefined. doi: 10.1080/21691401.2026.2632551. PMID: 41758521.

Huang J, Liu C. Protective mechanisms of Salvia miltiorrhiza extracts in ischemic heart disease models. Med Plant Res. 2025;15(5):233-243. doi:10.5376/mpr.2025.15.0025.

Li Q et al. Salvia miltiorrhiza Bunge root in the treatment of myocardial fibrosis: research progress and challenges. Front Pharmacol. 2025 Mar;16. doi:10.3389/fphar.2025.1583210.