Coronary heart disease (CHD) is one of the main causes of heart failure. An early and well-tolerated medication for long-term treatment is required to improve the quality of life and prognosis. In many countries, herbal medication is a frequently used therapeutic approach for a variety of diseases including chronic heart failure. Crataegus extract WS 1442 is a dry extract from hawthorn leaves and flowers containing 18.75% oligomeric procyanidines. To evaluate the effect of WS 1442 in patients with heart failure and CHD-related congestive heart failure, four studies with New York Heart Association classes II-III patients were analysed. After treatment with Crataegus extract WS 1442, patients with heart failure and CHD showed a significant improvement in left-ventricular ejection fraction compared with placebo. In addition, an increase in the difference in the pressure–heart-rate product and in the maximal work load was observed, indicating a favourable effect of WS 1442 in the treatment of CHD-related congestive heart failure.