Life Extension Magazine®

Arjuna improved the heart’s pumping ability

Help Your Heart Pump Better

In a clinical trial, a plant extract improved the heart’s pumping ability, increased ejection fraction and reduced physical fatigue by 23%.

Scientifically reviewed by: Gary Gonzalez, MD, in October 2024. Written by: Michael Downey.

Over time, our heart muscles weaken.

Age-related degenerative changes are often major culprits.¹

These changes may result in reduced efficiency of the heart to pump blood, which reduces the amount of oxygen that is pumped to the rest of our body. This often becomes symptomatic during periods of exertion or stress.^1-3

Weaker pumping of the left ventricle over time may result in debilitating cardio-vascular disease and even cardiac failure.⁴

For centuries, the arjuna plant has been used in Indian Ayurvedic medicine to treat heart disorders and other diseases.⁵

Modern research has found that arjuna supports cardiac function by strengthening the heart muscle's “squeeze,” increasing the volume of blood it can pump with each heartbeat.^6,7

Clinical trials show that a specific arjuna bark extract boosts the left ventricle's pumping output, supporting cardiac endurance and decreasing physical fatigue by a clinically significant average of 23%.^6,7

Measuring Cardiac Pumping Power

The ejection fraction test measures how effectively one's heart pumps blood during each heartbeat.

Testing left ventricular ejection fraction enables doctors to assess how effectively one's heart pumps blood out of the left ventricle. The left ventricle is the heart chamber that directly pushes oxygen-rich blood to the rest of the body.⁸

In a healthy heart, the left ventricular ejection fraction is usually 50% to 70%.⁸ A lower number indicates the heart is having trouble keeping up with your body's needs, especially under exertion. A left ventricular ejection fraction below 50% can indicate left-sided heart dysfunction.⁸

Left ventricular ejection fraction generally declines with age, though healthy eating, exercise, and reducing stress can help inhibit this decline.^3,4,9

In recent years, an extract of the arjuna tree has been clinically shown to increase left ventricular ejection fraction and improve cardiac output.

What Your Left Ventricular Ejection Fraction Means

Ejection fraction refers to the percentage of blood that is pumped out of the ventricles with each heartbeat.

It is a key measure used to assess how well the heart is functioning, particularly the left ventricle.

A physician can help interpret the implications of your left ventricular ejection fraction, or LVEF, number. But here is a general guideline:¹⁴

LVEF above 70% - Hyperdynamic (a possible sign of a heart condition)
LVEF 50% to 70% - Normal
LVEF 40% to 49% - Mild dysfunction
LVEF 30% to 39% - Moderate dysfunction

*LVEF below 30% - Severe dysfunction may indicate heart failure.

Arjuna Bark

Parts of the arjuna tree, which grows widely on the Indian subcontinent, have long been studied for medicinal properties.

In pre-clinical studies, bioactive compounds found in arjuna were shown to be:¹⁰

Anti-inflammatory,
Antioxidative,
Anti-atherosclerotic,
Cardioprotective, and
Anti-tumor.

Compared to the fruit, seed, leaf, and root of the tree, arjuna bark has a substantially higher concentration of flavonols (quercetin, myricetin, and kaempferol), flavanole (catechin), and phenolic acids (gallic acid, p-coumaric acid, and ferulic acid).¹⁰

These compounds appear to have the ability to increase the force of the heart's muscular contractions.^6,7 This improves pumping, increases cardiac output, and reduces physical fatigue.^6,7

Two randomized, controlled clinical studies have confirmed these benefits in an arjuna bark extract standardized to provide 30% polyphenols and 15% glycosides.^6,7

Better Pumping, Less Fatigue

In one study, researchers enlisted 72 male and female volunteers between the ages of 30–70 years, sedentary, and overweight. They had left ventricular ejection fraction ratios (assessed using a type of echocardiogram) ranging from 48% to 60%,⁶ which are mildly reduced to normal.

One group took 400 mg of arjuna extract daily for eight weeks, while another took a placebo. Both groups maintained normal dietary and exercise regimens.⁶

Those who took the arjuna increased their left ventricular ejection fraction by a clinically significant 3.6 percentage points, improving their cardiac endurance.⁶

Research shows that even modest changes in left ventricular ejection fraction may be clinically important in determining the risk of future mortality.^11,12

Physical fatigue levels were also evaluated, using a standard questionnaire that measures fatigue severity and how it affects activities and lifestyle.

Those who took the arjuna extract reported clinically significant improvement in fatigue scores¹³ with an average of 23% improvement, compared to less than 10% in the placebo group.⁶

Arjuna extract provided a decrease in fatigue's interference in:⁶

Physical functioning,
Sustained physical functioning, and
Performance of duties and responsibilities.

WHAT YOU NEED TO KNOW

Support Healthy Heart Function

With age, the heart's left ventricle loses its ability to effectively pump oxygen-rich blood to the body. Over time this may lead to cardiovascular disease/cardiac failure.
A standardized extract of arjuna tree bark has been shown to increase the left ventricular ejection fraction, a measure of how much blood the heart can pump out of the left ventricle with each heartbeat.
In a clinical study, arjuna extract increased left ventricular ejection fraction by a clinically meaningful 3.6% in participants in the mildly reduced to normal ranges. Their fatigue scores decreased by a clinically significant 23%.
A similar improvement in left ventricular ejection fraction was demonstrated in a clinical trial of active young men with LVEF numbers well into the healthy range, showing that arjuna improved cardiac output in a wide range of subjects.

Effects in Healthy Adults

Scientists also tested arjuna extract's effect on the heart's pumping capability in active adults with a healthy left ventricular ejection fraction.

Researchers enlisted 31 healthy, endurance-exercising men, aged 18-40 years. Their left ventricular ejection fraction scores ranged from 55% to 70%.⁷

All volunteers' left ventricular ejection fraction and fatigue levels were assessed after physical exertion on a treadmill.

After eight weeks, participants who took the arjuna extract had improved their already healthy left ventricular ejection fraction by a clinically significant 3.7 percentage points.⁷

This shows that this extract may benefit individuals whether their left ventricular ejection fraction is mildly reduced or healthy.

Researchers also used a scale measuring subjects' perceived exertion to assess physical fatigue. Those taking arjuna had statistically significant increase in time-to-exhaustion score, and their perceived level of exertion was significantly reduced.⁷

No serious adverse events were reported in either study.^6,7

Arjuna extract can help maintain a strong, healthy heart and decrease physical fatigue by increasing cardiac output.

Research suggests that arjuna extract may have potential to improve ejection fraction in patients with heart failure.^6,7 While preliminary studies are promising, more extensive clinical trials are needed to confirm these effects in heart failure patients who must rely on cocktails of drugs and nutrients to maintain barely sufficient cardiac output.

Summary

Over time, the heart's left ventricle tends to pump less oxygen-rich blood to your body.

This can eventually lead to cardiovascular disease/cardiac failure.

Clinical studies show that arjuna bark extract increases the left ventricular ejection fraction, a measure of the amount of blood the heart can pump out of the left ventricle with each heartbeat.

This ability to support healthy heart function was seen in individuals with mildly reduced and healthy left ventricular ejection fractions. Both groups also had a significant decrease in fatigue levels.

If you have any questions on the scientific content of this article, please call a Life Extension Wellness Specialist at 1-866-864-3027.

Aortic Stenosis and Transcatheter Aortic Valve Replacement (TAVR)

Aortic stenosis is a common disorder seen in adults 65 years and older. It involves scarring and calcification of the aortic valve.¹⁵

When working normally, the aortic valve helps ensure that blood flows in only one direction, blocking backward flow into the heart's left ventricle.¹⁶

But with age, heart valves can become diseased. The pathology reflects cardiac valve dysfunction, where calcium and scar tissue build-up impedes valve functionality, such as in aortic valve stenosis, which can also be genetic in origin.¹⁵ This makes the valve stiff and difficult to open.

Stenosis of the aortic valve puts a large stress on the heart and impairs its ability to function. Because the main output pathway from the heart is partially blocked, the heart muscles must work harder to get adequate blood supply to the entire body.¹⁵

Over time, as aortic stenosis worsens, it can significantly impair the cardiac output, becoming symptomatic. Symptoms such as shortness of breath, chest pain, and fainting can occur with physical exertion. As the stenosis gets worse, the heart can eventually fail to generate enough blood flow and heart failure develops.

Traditionally, the only option to correct aortic stenosis has been open heart surgery to replace the valve.¹⁵ Although this procedure can reverse aortic stenosis and take stress off the heart, it cannot be tolerated by all patients, especially the elderly.

Open heart surgery typically has long hospitalization and recovery times. Patients with severe disease or other age-related conditions may be poor candidates for open heart surgery. The stress of these procedures and long anesthesia times increase the risk of complications and poor outcomes.

Fortunately for people suffering from aortic stenosis, there is now another option. Transcatheter aortic valve replacement (TAVR) is an alternative treatment in many cases. It is an effective and less invasive endovascular procedure— meaning that it does not require the chest to be opened and it is done almost entirely through catheters in the blood vessels with x-ray guidance.¹⁷

The advantages of this technology are that it is much less traumatic than open heart surgery and the resulting hospitalization and recovery times are significantly reduced compared to open heart surgery.

TAVR may not be indicated for all patients, depending on various details of their condition and general health. Furthermore, while generally less traumatic than open heart surgery, TAVR is not without its own risks. As with surgical valve replacement, complications such as bleeding, stroke, and others can occur in some cases, as well as death.

However, a recent trial that randomized patients with aortic stenosis to TAVR versus surgery found that outcomes were largely comparable. Most notably, the occurrence of poor outcomes (death, stroke, rehospitalization related to the procedure, and heart failure) was not significantly different between the two options.¹⁸Therefore, this TAVR may be an option for a growing subset of patients suffering from symptomatic aortic stenosis who wish to avoid surgery or for whom open heart surgery is too risky.

References

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Strange G, Playford D, Scalia GM, et al. Change in ejection fraction and long-term mortality in adults referred for echocardiography. Eur J Heart Fail. 2021 Apr;23(4):555-63.
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Nordin A, Taft C, Lundgren-Nilsson A, Dencker A. Minimal important differences for fatigue patient reported outcome measures-a systematic review. BMC Med Res Methodol. 2016 May 26;16:62.
Wang S, Hu P. Deep Learning for Automated Echocardiogram Analysis. Journal of Student Research. 2022 03/14;11(3).
Available at: https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/heart-valve-problems-and-causes/problem-aortic-valve-stenosis. Accessed August 8, 2024.
Available at: https://www.nhlbi.nih.gov/health/heart/blood-flow. Accessed August 8, 2024.
Spilias N, Martyn T, Denby KJ, et al. Left Ventricular Systolic Dysfunction in Aortic Stenosis: Pathophysiology, Diagnosis, Management, and Future Directions. Struct Heart. 2022 Oct;6(5):100089.
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