Impact of Ayurveda-based Panchkarma Therapy in Change of the VO2peak in Congestive Heart Failure Patients - An Observational Study

Background and Aim: Reduced peak oxygen uptake (VO2peak) is a primary predictor of mortality in congestive heart failure (CHF) patients, and it is also an indicator of an individual's exercise capacity. Traditionally, exercise training during cardiac rehabilitation has been used to improve the patient's VO2peak. However, this may not apply to patients of all ages due to exercise intolerance. Therefore, this study focused on using ayurveda-based panchakarma treatment to increase maximal oxygen consumption during regular physical activities.

Methods: An observational study was conducted on 589 CHF patients who had opted for panchakarma treatment at various branches of Madhavbaug clinics. The patient's weight, body mass index (BMI), and blood pressure (BP) were measured before the start of the treatment. A 6-minute walk test (6MWT) and cardiac stress test with modified Bruce protocol were used to measure the initial VO2peak value for each patient. Using this value, the initial metabolic equivalent was calculated. The study population underwent a minimum of 7 sittings (twice a day) of panchakarma therapy for seven days. They were asked to follow up after 90 days. During the follow up, their weight, BMI, BP, VO2peak, and metabolic equivalent (MET) were measured and compared with the results of day 1.

Results: The study consisted of 589 CHF patients aged 20 to 90 years, of which 53.24% were males and 46.76% were females. There was a weight reduction (3.28 ± 1.24, p=0.0001), BMI (1.43 ± 0.5, p=0.0001), and blood pressure, and an increase in the VO2peak (8.18 ± 1.2, p=0.0001) and MET after the treatment. An age-wise comparison showed that the VO2 peak decreases with age and that the treatment's effect is seen more in younger patients. On the other hand, a similar improvement in oxygen consumption was seen in both genders. The treatment was also able to improve the VO2peak in patients with severe risk, i.e., those having an initial VO2peak value of <12mL/kg/min.

Conclusion: The ayurveda-based panchakarma treatment proved beneficial in improving the exercise capacity measured in VO2peak and MET, thus improving the exercise tolerance of the study population and reducing the risk of mortality.