Introduction
Cardiovascular disease remains the world’s leading cause of death, driving the need for innovative adjunctive therapies. Hyperbaric oxygen therapy (HBOT) – breathing 100% oxygen inside a pressurized chamber (typically 1.5–2.0 ATA) – elevates plasma oxygen levels 10‑ to 20‑fold. This enables oxygen to reach ischemic and hyperperfused cardiac tissue, forming the physiological basis for HBOT’s cardioprotective effects.
How HBOT Enhances Myocardial Function
HBOT acts through multiple molecular pathways:
•Anti‑inflammatory modulation – downregulates HMGB‑1, TLR‑4, NFκB and HIF‑1α, reducing systemic and cardiac inflammation.
•Angiogenesis – upregulates VEGF and EGF, promoting new vessel formation and myocardial repair.
•Anti‑apoptotic effects – inhibits programmed cell death in cardiac myocytes, preserving heart muscle during ischemia‑reperfusion injury.
These mechanisms work synergistically to improve cardiac contractility and overall myocardial performance.
Clinical Evidence: LVEF Improvement
Left ventricular ejection fraction (LVEF) is a key measure of heart pumping ability. A 2025 meta‑analysis in the British Journal of Cardiology pooled three observational studies (195 patients with coronary artery disease after reperfusion). HBOT significantly increased LVEF by 4.16% (95% CI 0.97–7.34, p=0.01) compared to controls, without changing ventricular volumes – indicating genuine contractility improvement.
In acute myocardial infarction, HBOT combined with reperfusion reduced creatine phosphokinase (CPK) levels by up to 35% (p=0.03) while improving LVEF (p<0.05), directly demonstrating reduced myocardial injury.
HBOT in Heart Failure and Cardiac Surgery
For chronic heart failure with reduced ejection fraction (HFrEF), an ongoing randomized trial is evaluating HBOT (3 courses of 10 sessions at 2.0 ATA) added to guideline‑directed “New Four Pillars” therapy. Retrospective data already confirm HBOT is safe and well tolerated in heart failure patients.
In cardiac surgery, preoperative HBOT preconditioning improves left ventricular stroke work, reduces postoperative myocardial injury, shortens hospital stays, and lowers inflammatory biomarkers (p<0.05). These benefits are especially valuable for high‑risk patients undergoing coronary artery bypass grafting (CABG) or valve surgery.
Additional Cardiovascular Benefits
HBOT also reduces the frequency and duration of premature ventricular contractions and paroxysmal tachycardia, and may lower neurological complications after atrial fibrillation ablation – a meaningful advantage given the small but serious stroke risk of ablation procedures.
Safety Profile
HBOT is generally well tolerated. Transient middle ear barotrauma and temporary myopia are the most common side effects, both typically resolving spontaneously. Serious pulmonary oxygen toxicity is rare under standard protocols (≤2.0 ATA, ≤120 minutes per session).
Conclusion
HBOT is a scientifically supported, non‑invasive adjunctive therapy that improves myocardial function across multiple cardiovascular conditions – acute myocardial infarction, chronic heart failure, perioperative cardiac surgery, and arrhythmias. Meta‑analysis data showing a 4.16% LVEF improvement, along with reduced injury markers and favorable safety, position HBOT as a valuable tool in integrative cardiovascular care.
For more information, consult a qualified hyperbaric medicine specialist.
References & Further Reading
Chen, S., et al. (2025). Hyperbaric oxygen therapy for coronary artery disease after reperfusion: a meta‑analysis of left ventricular function. British Journal of Cardiology.
https://bjcardio.co.uk/2025/01/hbot-coronary-artery-disease-meta-analysis/
Heyboer, M., et al. (2025). Hyperbaric oxygen therapy: cardiovascular mechanisms and clinical applications. Medical Gas Research, 15(1): 12‑22.
https://journals.lww.com/medgasres/fulltext/2025/01000/hyperbaric_oxygen_therapy_in_cardiovascular.3.aspx
Liu, R., et al. (2026). Systematic review of HBOT’s cardioprotective and anti‑inflammatory effects. Undersea & Hyperbaric Medicine, 53(2): 101‑114.
https://www.uhms.org/publications/uhm-journal.html
National Center for Biotechnology Information (NCBI). Hyperbaric Oxygen Therapy for Heart Failure – ClinicalTrials.gov ID NCT05823714.
https://clinicaltrials.gov/ct2/show/NCT05823714
Undersea and Hyperbaric Medical Society (UHMS). HBOT Indications: Cardiovascular Diseases.
https://www.uhms.org/resources/hbot-indications.html
