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Combined Enhanced External Counterpulsation and Hyperbaric Oxygen Therapy in Ischemic Cardiomyopathy: Interim Results

Dr Sama Akber1, Dr Natrajan Sivakadaksham2, Dr D Prabhakaran3

  • 1Oxymed Hospital, Chennai, Tamil Nadu, India.

Journal of Cardiac Failure
|May 8, 2026
PubMed

Insights

Enhanced External Counterpulsation (EECP) with Hyperbaric Oxygen Therapy (HBOT) significantly improves heart function and exercise capacity in patients with ischemic cardiomyopathy. This combination therapy offers a promising, non-invasive addition to standard heart failure management.

Area of Science:

  • Cardiology
  • Heart Failure Research
  • Regenerative Medicine

Background:

  • Ischemic cardiomyopathy is a primary cause of chronic heart failure, often persisting despite guideline-directed medical therapy (GDMT).
  • The HEAT HF study is the first prospective investigation into the combined efficacy of Enhanced External Counterpulsation (EECP) and Hyperbaric Oxygen Therapy (HBOT) for ischemic cardiomyopathy.

Purpose of the Study:

  • To evaluate the impact of adjunctive Hyperbaric Oxygen Therapy (HBOT) to Enhanced External Counterpulsation (EECP) on cardiac function and clinical outcomes.
  • To assess improvements in left ventricular ejection fraction (LVEF), exercise capacity, and heart failure-related hospitalizations.

Main Methods:

  • A prospective interventional study involving 100 adult patients with ischemic cardiomyopathy (LVEF ≤50%) who received EECP with HBOT.
  • Collected pre- and post-intervention data included LVEF, global longitudinal strain (GLS), NYHA class, 6-minute walk test (6MWT), NT-proBNP, and hospitalizations.

Main Results:

  • Significant improvements observed in LVEF (34.17% to 41.43%), 6MWT distance (243.7m to 367.4m), and NYHA class (III/IV to I).
  • Global longitudinal strain (GLS), NT-proBNP levels, and heart failure admissions showed marked reductions (p < 0.001).
  • Patients receiving more GDMT agents demonstrated enhanced LVEF improvements, indicating a synergistic effect.

Conclusions:

  • The combination of EECP, HBOT, and optimal GDMT significantly enhances cardiac function, exercise tolerance, and reduces symptom burden in ischemic cardiomyopathy.
  • This non-invasive therapeutic strategy presents a potentially valuable adjunct to conventional heart failure management.
Abstract

Keywords:
6MWTEECPGDMTHBOTIschemic cardiomyopathyejection fractionheart failure

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