Terminalia arjuna (commonly known as Arjuna) is an herb traditionally used in Ayurveda for various heart-related ailments, including Congestive Heart Failure (CHF). Its use for heart conditions, including CHF, is well documented in traditional texts like the Charaka Samhita and Ashtanga Hridaya. More recently, scientific studies have begun to evaluate its efficacy in modern clinical settings.

Several small-scale, randomized controlled trials and observational studies have been published, primarily from India, assessing Arjuna's effects in CHF patients. These studies often use standardized Arjuna bark extracts as adjunct therapy alongside conventional heart failure medications. Reported benefits include improvement in symptoms (such as dyspnea and fatigue), enhanced left ventricular ejection fraction, and improved exercise tolerance. Some studies also noted reductions in BNP (B-type natriuretic peptide) levels, a marker of heart failure severity.

The mechanisms proposed for Arjuna’s benefit include antioxidant effects, improvement of endothelial function, and mild diuretic and inotropic actions. However, these studies typically have small sample sizes and short follow-up periods, and there is a lack of large, multicenter trials. Systematic reviews conclude that while results are promising and suggest potential benefit, the evidence is not yet robust enough for widespread clinical recommendation outside adjunctive settings.

In summary, Arjuna’s use in CHF is supported by both tradition and a growing—but still limited—body of scientific evidence.