Panax ginseng enhances the effect of metoprolol in chronic heart failure by inhibiting autophagy

Context Panax ginseng is often used as an adjuvant therapy for heart failure (HF) patients. Metoprolol is widely used in patients with HF. However, there is currently no report on the combined effects of ginseng and metoprolol in patients with HF. Objective The objective of this study is to investigate the combined effects of ginseng and metoprolol in patients with HF and the exact mechanisms. Materials and methods A mouse myocardial HF model was used. The serum levels of CK and CK-MB were determined using an automated biochemical analyzer. LDH and cTnT levels were determined using enzyme-linked immunosorbent assays. Autophagy of myocardial cells was evaluated using transmission electron microscopy, and changes in signal pathway proteins related to autophagy were analyzed using Western blot. Results The combination of ginseng and metoprolol can increase the survival rate of HF mice, improve heart function, reduce heart damage, and reduce serum CK, CK-MB, LDH, and cTnT levels. The combination of ginseng and metoprolol reduces autophagy in myocardial cells, reduces the levels of autophagy-related proteins (LC3, p62, Beclin1, and Atg5), and increases the p-PI3K/PI3K, p-Akt/Akt, and p-mTOR/mTOR ratios. Discussion and conclusion Ginseng enhances the anti-HF effect of metoprolol. Its mechanism of action may be related to inhibition of autophagy mediated by the PI3K/Akt/mTOR pathway. ### Competing Interest Statement The authors have declared no competing interest.