North American ginseng protects the heart from ischemia and reperfusion injury via upregulation of endothelial nitric oxide synthase

► Role of endothelial nitric oxide synthase (eNOS) in the cardioprotection of ginseng was studied. ► Ginseng increased eNOS expression and inhibited anoxia/reoxygenation (A/R)-induced apoptosis in cultured cardiomyocytes. ► In vivo ginseng treatment increased myocardial eNOS expression in wild-type (WT) mice. ► Ginseng decreased myocardial apoptosis and infarct size following ischemia and reperfusion (I/R) in WT but not eNOS−/− mice. ► We conclude ginseng protects the heart from I/R injury via upregulation of eNOS.