苦参碱对心脏具有正性肌力、负性频率和负性自律性的作用，因此具有广谱的抗心律失常作用。苦参碱对冠脉结扎缺血、缺血再灌注、异丙肾上腺素、高血脂、糖尿病和阿霉素引起的心肌损伤都有保护作用。苦参碱还能阻滞心肌肥大和纤维化的发生、发展。苦参碱保护心脏作用的基本机制是抗氧化、抗炎、降血糖、调血脂作用，由此抑制ROS/TLR4信号通路、PI3K/Akt信号通路和TGF-β诱导的PERK信号通路，激活Akt和STAT3信号通路和AMPKα/UCP2信号通路，上调JAK2/STAT3通路上的HSP70以及JNK、ASK1、eNOS和一氧化氮的表达，提高线粒体ATP酶活性，保护线粒体而减少心肌细胞凋亡、减轻心肌损伤和抑制胶原合成，从而抑制心肌肥大和纤维化。从抗各种心肌缺血性损伤、抗阿霉素诱导的心肌损伤、抗高糖性心肌损伤、抗心肌肥大和纤维化4个方面综述苦参碱的心脏保护作用及其机制。

Matrine has positive inotropic action, negative chronotropic action, and negative automatic action, so it possesses a broad-spectrum antiarrhythmic effect. Matrine has the protective action against myocardial injury induced by coronary artery ligature-induced ischemia, ischemia/reperfusion, isoproterenol, hyperlipoidemia, hyperglycemia, and adriamycin. Matrine can block to occurrence and development of myocardial hypertrophy and fibrosis. The basic mechanisms of cardioprotective effects of matrine are antioxidation, anti-inflammation, hypoglycemia, and hypolipemia, thus inhibiting signaling pathways of ROS/TLR4, PI3K/Akt, and TGF-β-induced PERK, and activating signaling pathways of Akt, STAT3, and AMPKα/UCP2, to up-regulate the expressions of HSP70 in JAK2/STAT3 pathway, JNK, ASR1, eNOS, and NO, and to increase activity of ATPase in mitochondria and to protect mitochondria, deceasing myocardial apoptosis, and preventing myocardial injury and collagen synthesis, so attenuating myocardial hypertrophy and fibrosis. This article reviews the cardioprotective effect and mechanism of matrine from four aspects:anti-myocardial ischemic injury, anti-adriamycin induced myocardial injury, anti-high glucose induced myocardial injury, and anti-myocardial hypertrophy and fibrosis.

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