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Cardiac stimulant activity of bark 
and wood of Premna serratifolia   

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Introduction 

Cardiovascular disease incurs a greater economical 
constraint than any other illness especially in the 
developing countries. It is the most common cause of 
death by the year 2020. The risk factors for heart disease 
are family history, sex, increased lipid levels, diabetes 
mellitus, hypertension, obesity and cigarette smoking. 
There is overwhelming evidence indicating 
hypercholesterolemia and other lipid abnormalities as 
major risk factors in the development of atherosclerosis 
and coronary heart disease. Therefore, cardiovascular 
disease becomes a very common problem in the 
affluent societies related to their life style (Trivedi, 
2004). 

In developed countries, coronary vascular diseases 

now constitute the principal cause of human mortality. 
Not surprisingly, therefore, this is an intensive 
research, not entirely devoted to treatment, but also to 
the prevention of these diseases. Many factors affect 
the complex regulation of the heart and there is a large 
group of drugs which will affect the heart’s 
performance, often in a manner not directly associated 
with the heart muscle itself. However, the therapeutic 
use of drugs for the treatment of the failing heart is 
confined to a small group of glycosides that act directly 
on the heart muscle (Evans, 1996). Cardiovascular 
disorder leads to variety of pathological changes 
including endothelial, pulmonary, hepatic, renal, 
endocrine, skeletal muscle abnormalities and the state 
of multi-organ impairment (Poole-Wilson et al., 1997). 
Cardiac glycosides and catecholamine have been used 

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Cardiac stimulant activity of bark and wood of Premna serratifolia   

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Received:                               5 July 2008 
Accepted:                            20 July 2008 
Available Online:               27 July 2008  
 
DOI: 10.3329/bjp.v3i2.952 
 
 
 
 
 
 

Cite this article: 
Rajendran R, Suseela L, Sundaram R 
M, Basha NS. Cardiac stimulant activ-
ity of bark and wood of Premna serrat-
ifolia. Bangladesh J Pharmacol. 2008; 
3: 107-13. 

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Premna serratifolia Lin., (Verbenaceae) contains alkaloids and iridoid glycoside 
and is believed to prevent cardiovascular disease. The stem-bark and stem-
wood were extracted with 95% ethanol and distilled water. These extracts 
were screened for their effects by "Isolated Frog Heart Perfusion Technique" 
and biochemical parameters in heart tissue and serum of albino rats after 
administering the extracts for 7 days. The ethanol extract produced significant 
positive ionotropic and negative chronotropic actions similar to that of 
digoxin on frog heart and its effect was in hibited by nifedipine but not by 
propranolol. A significant decrease in membrane Na+K+ATPase and 
Mg2+ATPase and an increase in Ca2+ATPase further confirmed its cardiotonic 
activity. Aqueous extract produced positive ionotropic and chronotropic 
effects similar to that of adrenaline and its effect was antagonized by 
propranolol and nifedipine. The results suggest that the ethanol extract 
produced cardiotonic effect and the aqueous extract produced β-adrenergic 
effect. 

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as the main therapeutic drugs in the treatment of 
coronary heart disease (Kitada et al., 1987). There is no 
evidence that digitalis prolongs survival of coronary 
heart disease patients (Tripathi, 2001), major 
limitations in the use of cardiac glycosides are low 
margin of safety, inability to retard the process which 
caused the heart to fail and intoxification are well 
documented (Beller et al., 1971).  Catecholamine use is 
limited by its, insufficient differentiation between 
positive ionotropic and chronotropic actions, potential 
arrthythmogenic properties, tachyphylaxis due to 
receptor down-regulation and causes a severe 
oxidative stress in the myocardium through free 
radical formation (Kitada et al., 1987). There are so 
many popular herbs used in traditional practices to 
cure cardiovascular problems. Premna serratifolia Lin., 
is having an important place in such cardiovascular 
medicinal herbs (Yoganarasimhan, 2000) and its 
synonym is Premna integrifolia Lin. It is known as 
“Munney” in Tamil, “Agnimantha” in Ayurveda and 
used as cardiotonic, antibiotic, antihyperglycemic 
(Natkarni, 1976). It is widespread throughout 
Micronesia and tropical Asia. Root forms an ingredient 
in well known Ayurvedic formulation “Dasamula” for 
variety of affections (Anonymous, 1972). It has shown 
anticoagulant activity (Gopal and Purushothaman, 
1984) and the decoction exhibited anti-inflammatory 
and antiarthritic activity (Rathore et al., 1977). 
However, its cardiotonic activity has not been 
investigated still now. Hence it was considered to 
evaluate the cardioactive potential and its mechanism 
of action. 

 

Materials and Methods 

Preparation of extracts 

Fresh stem-bark and stem-wood of P. serratifolia Lin., 
was collected from The Indian Medical Practitioners 
Co-operative Pharmacy and Stores garden, Chennai, 
Tamil Nadu. Plant material was identified and 
authenticated (PARC/2007/71) by a Botanist, Dr. P. 
Jayaraman, Plant Anatomical Research Centre, 
Chennai. Materials were cleaned with water and dried 
in the shade until a constant weight was obtained. It 
was extracted with 95% ethanol and double distilled 
water in a Soxhlet extractor. Extracts were 
concentrated; the percentage yield for ethanol and 
aqueous extracts were 7.9 and 7.7%. For 

pharmacological studies, since the ethanol extract was 
not soluble in water, it is suspended in 5% gum acacia 
and aqueous extract was being water soluble, hence an 
aqueous solution was used. 

Drugs and chemicals 

Digoxin, adrenaline, propranolol and nifedipine were 
procured from Government General Hospital, 
Chennai. All other chemicals used were of higher 
quality analytical grade. 

Animals 

Frogs of Rana hexadactyla species (procured from animal 
house of Madras Medical College) and male Wister 
albino rats (200 g) housed in cages at 27 ± 2°C 

 on a 12 hours light/dark cycle was used. The animals 
were fed with food and water ad libitum. The animals 
were maintained as per the norms of CPCSEA (6/243/
CPCSEA/2007) and cleared by CPCSEA and 
institutional ethics committee (Madras Medical 
College). 

Phytochemical screening 

Ethanol extract showed positive reaction for alkaloids, 
glycosides, flavonoids and steroids whereas the 
aqueous extract showed positive reaction for alkaloids, 
glycosides and phenolic compounds. HPTLC profile of 
ethanol extract showed 10 peaks in the solvent system 
of n-hexane: ethylacetate (3:1) at 260 nm and aqueous 
extract showed 7 peaks in the solvent system of 
chloroform: methanol: water (7:2.6:0.4) at 260 nm. 

Isolated frog heart perfusion technique (Muralidharan 
and Dhananjayan, 2004) 

Frogs were pithed and heart was exposed. The inferior 
vena cava was traced and cannulated for perfusing the 
heart with the frog's Ringer solution. (Composition of 
frog Ringer solution in mmol: NaCl-110; KCl-1.9; CaCl2

-1.1; NaHCO3-2.4; NaH2PO4-0.06; Glucose-11.1). The 
basal cardiac contraction was recorded on a smoked 
kymographic drum after the administration of frog 
Ringer's solution and 5% gum-acacia. Administration 
of gum acacia was done to see that it did not contribute 
to the effects of extracts. Drugs and extracts were 
administered through the cannula. The average heart 
rate and the contraction amplitude were recorded on a 
smoked kymographic drum and it was found to be 64 
beats/min and 8 mm respectively. The effects obtained 
with the drugs and extracts were transposed to the 

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respective percentage of the basal values. Graded dose-
response was recorded for each extract and the dose 
which caused the maximum effect was chosen as the 
experimental dose. The frog heart was washed with the 
Ringer solution after every administration of extracts 
and drugs till it was brought back to the normal state. 
The frog heart was perfused with propranolol, at 30 µM 
concentration in frog Ringer solution for 60 sec 
followed by the administration of extracts and the 
recording were noted. Nifedipine, at 28.8 µM 
concentration in frog Ringer solution was administered 
for 60 sec followed by extracts and the recordings were 
noted. 

Biochemical studies in Wistar albino rats 

Animals were randomized into 3 groups of 6 rats each. 
Group I was treated with gum acacia suspension i. p. 
for 7 days which served as control. Group II and III 
animals were treated with ethanol and aqueous 
extracts at a dose of 200 mg/kg (approximately 1/10 of 
the LD50) body weight i. p. for 7 days. On 8th day, all 
the animals from 3 groups were sacrificed. Blood was 
collected by cardiac puncture and heart-tissue was 
collected and serum was separated from the blood. The 
heart was washed in ice-cold saline and 100 mg of 
tissue was weighed and homogenized in chilled 0.1 M 
Tris-HCl Buffer (pH 7) and the homogenate was used 
for the assay of Na+K+ATPase (Bonting, 1970), 

Ca2+ATPase (Hjerten and Pan, 1983) and Mg2+ ATPase 
(Ohinishi et al., 1982). Serum and homogenized 
samples were assayed for the clinical marker enzymes 
like CPK (Okinaka et al., 1961), LDH (King, 1965a), AST 
and ALT (King, 1965b).  

Histopathological studies 

A portion of heart from each group was stored in 10% 
formalin, for processing and sectioning. By following 
routine histological techniques, these samples were put 
into paraffin and serial cross sections of 5 µm, which 
were taken from tissue blocks stained with 
hematoxylin and eosin. The preparations were 
evaluated under a photomicroscope and were 
photographed. 

Statistical analysis 

Results were expressed as mean ± standard error for 6 
animals in each group. Differences between groups 
were assessed by one-way ANOVA using Bonferroni 
test. Post hoc testing was performed for inter-group 
comparisons using the least significance difference test. 
p<0.05 have been considered as significant. 

 

Results  

Ethanol extract produced significant positive 
ionotropic and negative chronotropic effects similar to 
that of digoxin on frog heart and it is indicated by an 
increase in the force of contraction (Table I) and a 
decrease in the heart rate (Table II). This cardiotonic 
effect of the ethanol extract was not antagonized by 
propranolol, whereas nifedipine treatment significantly 
reduced the cardiotonic effect. There was a significant 
decrease in membranous Na+K+ATPase and 
Mg2+ATPase (p<0.05) and an increase in Ca2+ATPase 
(Table III) when compared with that of the control and 
this further confirmed its cardiotonic effect. 

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Table I 

Effect of Premna serratifolia extract on force of contraction using isolated frog heart perfusion technique 

 Frog Ringer  Frog Ringer + propranolol 
(1 mg/mL)   

 Force of contraction 
(mm) 

Change 
(%) 

Force of contraction 
(mm) 

Change 
(%) 

Force of contraction 
(mm) 

Change 
(%) 

Digoxin 14.1 ± 0.40ae 76.3 - - 10.3 ± 0.7ae 28.8 

Adrenaline 21.5 ± 0.56a bd 168.8 13.6 ± 0.3ae 70.0  - 

Ethanol extract 14.8 ± .30a ce 75.4 14.2 ± 0.4ae 77.0 10.6 ± 0.5ae 32.5 

Aqueous extract 20.5 ± 0.32a bd 156.3 16.1 ± 0.7acd 101.3 13.8 ± 0.7abd 72.5 

F value 196.219  63.836  19.448  

P value <0.001  <0.001  <0.001  
Control value of force of contraction: 8 ± 0.06 mm. n = 6. Values are mean ± SE. Values with different superscripts in a column are significantly 
different from each other at p<0.05 significant, by one-way ANOVA using Bonferroni test. acomparison with control; bcomparison with Digoxin; 
ccomparison with adrenaline; dcomparison with ethanol extract; ecomparison with aqueous extract  

Frog Ringer + nifedipine 
(1 mg/mL)   



 

 

Aqueous extract produced a significant positive 
ionotropic and positive chronotropic actions similar to 
that of Adrenaline on frog heart and it is indicated by 
an increase in the force of contraction and the heart 
rate. Propranolol and nifedipine antagonized the effect 
of the aqueous extract. No significant changes were 

observed in membrane bound phosphatase in rat. 

Both the extracts do not produce any significant 
changes in the levels of CPK, LDH, AST and ALT in 
heart and in serum samples when compared to that of 
the control (Table IV). Therefore, it indicated that both 

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Table II 

Effect of Premna serratifolia extract on heart rate using isolated frog heart perfusion technique  

Heart rate (per min) 

Frog Ringer 
 

Frog Ringer + propranolol 
(1 mg/mL) 

Frog Ringer + nifedipine 
(1 mg/mL) 

Digoxin 58.6 ± 0.4ce - 55.0 ± 0.6d 

Adrenaline 136.3 ± 0.8abde 107.0 ± 0.7ad - 

Ethanol extract 57.8 ± 0.7ce 59.5 ± 0.3ce 37.6 ± 0.5abe 

Aqueous extract 108.2 ± 0.5abcd 96.3 ± 0.8ad 55.8 ± 1.1d 

F value 246.27 96.30 13.22 

P value <0.001 <0.001 <0.001 
Control value of heart rate: 66.0 ± 1.25 /min; n = 6. Values are mean ± SE. Values with different superscripts in a column are significantly differ-
ent from each other at p<0.05 significant, by one-way ANOVA using Bonferroni test. acomparison with control; bcomparison with digoxin; ccom-
parison with adrenaline; dcomparison with ethanol extract; ecomparison with aqueous extract 

 

Table III 

Effect of the extracts of Premna serratifolia extract on membrane bound phosphatases in rats 

 Groups    Na+K+ATPase  Ca2+ATPase  Mg2+ATPase 

 Control  0.5 ± 0.02  0.2 ± 0.01  0.4 ± 0.01 

 Ethanol extract  0.4 ± 0.01a*b*  0.4 ± 0.01a*b*  0.3 ± 0.01a*b* 

Aqueous extract  0.5 ± 0.01b*c*  0.3 ± 0.01 b*c*  0.4 ± 0.004 b*c* 

F value  25.57  56.017  19.531 

p value  <0.001  <0.001  <0.001 

n = 6; Values are mean ± SE; aComparison with control; bComparison with ethanol extract;  cComparison with aqueous extract; p<0.05 signifi-
cant, by one-way ANOVA using Bonferroni test; Enzyme unit: micromoles of phosphorous liberated/min/mg of protein  

Table IV 

Effect of the extracts of Premna serratifolia n the clinical marker enzymes in rats 

Marker enzymes   Control  Ethanol extract  

Heart Serum Heart Serum Heart Serum 

Creatinine phosphokinase 0.6 ± 0.01 0.6 ± 0.01 0.6 ± 0.01 8.9 ± 0.01 0.6 ± 0.01 9.0 ± 0.01 

Lactate dehydrogenas 2.9 ± 0.03 2.9 ± 0.03 2.9 ± 0.03 5.6 ± 0.02 3.0 ± 0.05 5.2 ±  0.03 

Alanine transaminase 0.1 ± 0.01 0.1 ± 0.01 0.1 ± 0.01 0.6 ± 0.01 0.1 ± 0.01 0.6 ± 0.01 

Aspartate transaminae 0.2 ± 0.01 0.2 ± 0.01 0.2 ± 0.01 0.5 ± 0.01 0.2 ± 0.01 0.5 ± 0.01 

n = 6; values are expressed as mean ± SE; Enzyme units- for heart creatinine phosphokinase: µmoles of phosphorus liberated/min/mg protein, 
For serum creatinine phosphokinase: µmoles x 10-3 of phosphorus liberated/min/mg protein; Lactate dehydrogenase: µmoles x 10-1 of pyruvate 
liberated/min/mg protein. Aminotransferases: µmolesx10-2 of pyruvate liberated/min/mg protein 

Aqueous extract  



 

 

the extracts do not altered the physiological conditions 
of the heart. 

Histopathological studies of both the extracts do not 
produce any significant pathological changes in the 
heart when compared to that of the control (data not 
shown) and therefore it is indicated that both the 
extracts do not altered the physiological conditions of 
the heart.  

 

Discussion  

Ethanol extract produced cardiotonic effect, which was 
characterized by positive ionotropic and negative 
chronotropic actions. This effect was not significantly 
blocked by propranolol whereas nifedipine, 
antagonized the effect significantly. Cardiac enzyme 
profile indicates that the ethanol extract exhibited 
powerful cardiotonic like activity which manifested as 
a result of general decrease in the activity of 
Na+K+ATPase and Mg2+ATPase and an increase in 
Ca2+ATPase.  

Most important electrolytes like sodium, potassium, 
calcium, magnesium and bicarbonate provide 
inorganic chemicals for biochemical processes as well 
as act at the cell membrane to allow transmission of 
electrochemical impulse in nerve and muscle fibers 
(Kokko and Tannen, 1990). The intracellular cation 
plays a significant role in the regulation of normal 
physiology and biochemistry of cardiac and smooth 
muscles. Dysregulation of these processes is an 
important factor in the genesis of various serious 
arrhythmias (Bassett et al., 1997). Various studies have 
reported inhibition of Na+K+ATPase activity during 
cardiovascular problems (Less, 1991). This inhibition of 
Na+K+ATPase is similar to the action of cardiac 
glycosides (Akera and Brody, 1997). Cardiac glycosides 
are specific and unique inhibitors of Na+K+ATPase at 
normal concentrations (10-8 to 10-9M) (Goto et al., 1992). 
Na+K+ATPase inhibition by cardiac glycosides leads 
ultimately to increase intracellular Ca2+ concentrations 
through Na+/Ca2+ exchange and an associated increase 
in slow inward Ca2+ current (Wang et al., 2002)  as well 
as in transient Ca2+ current (McGarry and Williams, 
1993). Ca2+-induced Ca2+ release is a general mechanism 
that most cells use to amplify Ca2+ signals (Wang et al., 
2002). In heart cells, this mechanism is operated 

between voltage-gated L-type calcium channels (LCCs) 
in the plasma membrane and calcium release channel 
in the sarcoplasmic reticulum (Fabiato, 1985). 
Nifedipine is a LCC antagonist (Wang et al., 2002). 
Since nifedipine, blocks the cardiotonic action of the 
ethanol extract significantly, the extract might have 
produced its action by opening the voltage sensitive 
slow Ca2+ channel. In connection with the cardiotonic 
effects observed one could see a relationship that exists 
between the inhibitory levels of the activities of 
Mg2+ATPase and Na+K+ATPase (Chen et al., 1992). The 
significant rise in the level of activity of Ca2+ATPase 
might be due to the rise of cytosolic Ca2+  (Kelly and 
Smith, 1996). Therefore this cardiotonic action of the 
ethanol extract might be attributed to the 
phytoconstituents present in it. 

Aqueous extract produced positive chronotropic and 
positive ionotropic effects which were antagonized by 
propranolol indicating that these might have been 
mediated through ß-adrenergic receptors. Nifedipine 
also blocks the action of the aqueous extract.  

CPK is found in high concentration in skeletal muscle, 
myocardium and brain but not found in liver and 
kidney, small amounts are found in lungs not found in 
RB cells and its level is not affected by hemolysis. It 
appears to be a sensitive measure of myocardial 
infarction. LDH has gained much clinical interest 
recently and measurement of its activity in blood is 
considered useful in the diagnosis of certain 
cardiovascular disease conditions. AST level increase 
markedly in conditions of extensive damage to muscle 
especially cardiac muscles. Estimation of this enzyme is 
widely sought for, to confirm diagnosis of myocardial 
infarction. In pathological conditions, the enzymes 
such as CPK, LDH, AST and ALT leak from the 
necrotic heart cells to the serum, which are important 
measures of cardiac injury. These enzymes are not 
specific for myocardial injury individually; however, 
evaluation of these enzymes together may be an 
indicator of myocardial injury (Al-Shabanah et al., 
1998; Chopra et al., 1995). Levels of CPK, LDH, AST 
and ALT of ethanol and aqueous extracts do not 
changed when compared to that of the control both in 
the serum and also in the heart. Therefore, it confirms 
that both the extracts does not altering the 
physiological conditions of the heart when given at the 
dose of 200 mg/kg body weight.  

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Acknowledgement 

Authors would like to thank the Department of 
Pharmacognosy and Pharmacology, Madras Medical College, 
Chennai, for providing the necessary facilities for the 
completion of the work. 

 

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Rekha Rajendran (Principal contact) 
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	DatePrinted: This article was downloaded by you on: Feb 14, 2018