Effect of Thermal Therapy on Clinical Status, Neurohumoral Factors and Endothelial Function in Patients With Chronic Heart Failure

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(Objectives) Thermal therapy has been shown to improve hemodynamics and clinical symptoms in patients with congestive heart failure (CHF). In this study, effects of 4 week thermal therapy on clinical status, circulating levels of neurohormone and cytokine, and endothelial function were investigated. (Methods) To assess the effects of chronic thermal therapy, blood pressure, heart rate, CTR on X-ray, clinical symptoms, 6-minute walk distance (6MWD), LVEF in echocardiography, plasma neurohormone and cytokine levels and endothelial function were investigated before and after the 4 week thermal therapy by dry sauna bathing (15 to 20 minutes at 60t, once a day, 5 times a week) in patients with CHF with NYHA II or III (LVEF : 279%). (Results) The 4 week thermal therapy significantly increased 6MWD in all patients (357120 to 429 138 m, p<0.005), whereas no significant changes were observed in blood pressure, heart rate, CTR, body weight and LVEF. Plasma levels of ANP and BNP did not change significantly, whereas plasma norepinephrine (681±111 to 460±173 pg/mI, p<O.O5) and IL-6 (3.91±2.0 to 3.1±1.7 pg/ml, p<0.05) were significantly decreased. However, the thermal therapy did not significantly alter %FMD(% change in flow mediated diameter) after reactive hyperemia in forearm arteries and pak flow increase measured by strain gause plethysmography. (Conclusions) These results suggest that chronic thermal therapy is well tolerated and may improve the exercise capacity in CHF associated with decrease in sympathetic nerve activity and reduction of plasma IL-6 level. However, this therapy did not alter the endotheliial function in patients with chronic heart failure.