Enhanced external counterpulsation (EECP) is an outpatient coronary artery disease (CAD) therapy that involves the cyclical inflation/deflation of cuffs wrapped around the lower extremities. However, the possible benefits of EECP in patients with heart failure (HF) (New York Heart Association [NYHA] classes II to IV) and cardiomyopathy are unclear.

Inclusion Criteria:

• Patients with heart failure (NYHA II-IV)

  1. with optimal medical therapy
  2. caused by ischemic or non-ischemic cardiomyopathy

• EECP-Therapy and Treatment in the Cardio Centrum Berlin or Charité - University Medicine Berlin

• Aged 18 to 100 years

• Offered patient information and written informed consent

Exclusion Criteria:

• Participation in another interventional trial
• Acute coronary syndrome < 4 weeks prior to enrollment
• Operation < 4 weeks prior to enrollment
• Stroke < 4 weeks prior to enrollment
• Clinically significant disease with hospitalization
• Aortic valvular heart disease ≥ moderate
• Aortic aneurysm
• clinically relevant severe cardiopulmonal diseases
• Resting RR > 160/90mmHg
• Thrombose, Thrombophlebitis < 8 weeks prior to enrollment
• Peripheral artery occlusive disease ≥ Stadium II
• Acute Heart failure
• Pathological bleeding tendency
• Arrhythmias, which interfere with Triggering of the EECP
• Other diseases, that inhibit EECP-Treatment (e.g. Spinal disc herniation)
• Accommodation in an institution due to an official or judicial order
• Women: pregnancy or lactation

Patients with heart failure (NYHA II-IV)

• with optimal medical therapy
• arisen from ischemic or non-ischemic cardiomyopathy