Efficacy of heart failure reversal treatment in patients with low ejection fraction

Abstract

Background: Heart failure reversal therapy (HFRT) is designed to enhance cardiorespiratory fitness of chronic heart failure (CHF) patients. Objective(s): The present study was designed to evaluate efficacy of HFRT that uses herbal procedure (panchakarma) and allied therapies, in CHF patients with low ejection fraction. Methods: This efficacy study was conducted in CHF patients (aged: 25–65 years, ejection fraction (EF) 10–30%) wherein HFRT (60–75 min) consisting of snehana (external oleation), swedana (passive heat therapy), hrudaydhara (concoction dripping treatment) and basti (enema) was administered twice daily for 7 days. During this therapy and next 30 days, patients followed the study dinarcharya and were prescribed ARJ kadha in addition to their conventional treatment. The primary endpoint of this study was evaluation of maximum aerobic capacity uptake (MAC) as assessed by 6 min walk distance (6MWD) using Cahalins equation from baseline, at the end of 7 day treatment, follow-up after 30 days and 90 days. EF was assessed by 2D Echo at baseline and after 30 days of follow-up. Results: Fifty-two CHF patients with 10–30% EF (mean [SD] age: 58.8 [10.8], 85% men) were enrolled in the study. There was a 100% compliance to study therapy. A significant improvement was observed in MAC levels (7.11%, p = 0.029), at the end of 7 day therapy as compared to baseline. This improvement was maintained at two follow-up visits. Moreover ejection fraction was observed to be increased by 6.38%, p = 0.012 as compared to baseline at day 7 of the therapy. Conclusion: This 90 day follow up study highlights the benefit of HFRT, as a part of maintenance treatment for CHF patients with reduced ejection fraction. Keywords: Chronic heart failure, Heart failure reversal therapy, Oxygen uptake, Functional capacity, Panchakarma