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Yangxinshi (YXS) is a Traditional Chinese Medicine (TCM) herbal formula composed of thirteen distinct herbal components, including senkyunolide H, apigenin, and various astragalosides. It is officially recognized in the Chinese Pharmacopoeia and is primarily indicated for chronic heart failure (CHF) and coronary heart disease. The formula acts by modulating cardiac energy metabolism; specifically, it inhibits the FOXO1/PDK4 signaling pathway and activates the PI3K/Akt/mTOR/rpS6/HIF-1α and AMPK/PGC1α/GLUT4 pathways. These molecular actions collectively promote mitochondrial biogenesis, enhance oxygen delivery, and improve glucose utilization in the myocardium. Clinical evidence suggests that Yangxinshi, when combined with standard heart failure treatments, improves left ventricular ejection fraction (LVEF), increases exercise tolerance (as measured by the 6-minute walk test), and reduces NT-proBNP levels.
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