1. A warm footbath improves coronary flow reserve in patients with mild-to-moderate coronary artery disease.

Echocardiography. 2011 Nov;28(10):1119-24. doi: 10.1111/j.1540-8175.2011.01493.x. Epub 2011 Aug 19.

Yoon SJ, Park JK, Oh S, Jeon DW, Yang JY, Hong SM, Kwak MS, Choi YS, Rim SJ, Youn HJ.

Source: Division of Cardiology, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.

Abstract

BACKGROUND: Recent studies have shown that thermal therapy by means of warm waterbaths and sauna has beneficial effects in chronic heart failure. However, a comprehensive investigation of the hemodynamic effects of thermal vasodilation on coronary arteries has not been previously undertaken. In this study, we studied the effect of a warm footbath (WFB) on coronary arteries in patients with coronary artery disease (CAD), as well as any adverse effect.

METHODS: We studied 21 patients (33.3% men, mean age 60.8 ± 13.5 years) with CAD. Coronary flow Doppler examination of the left anterior descending coronary artery and coronary flow reserve (CFR) were performed and measured using adenosine before and after a WFB.

RESULTS: Systolic and diastolic blood pressure and heart rate did not change with the WFB. Mean velocity of diastolic coronary flow significantly increased (diastolic mean flow velocity: 18.3 ± 7.1 cm/sec initial, 21.5 ± 8.0 cm/sec follow-up, P = 0.002) and CFR significantly improved (1.6 ± 0.4 vs. 2.2 ± 0.5, P < 0.001) after WFB. The WFB was well accepted and no relevant adverse effects were observed. The change of CFR after WFB correlated well with diastolic function (E’, r = 0.51, P = 0.031; E/E’, r =-0.675, P = 0.002).

CONCLUSIONS:  A Warm Footbath significantly improved coronary flow reserve (CFR) without any adverse effects in patients with mild-to-moderate coronary artery disease (CAD) and can be applied with little risk of a coronary artery event if appropriately performed.

2. Repeated Far Infrared (FIR) sauna therapy reduces urinary 8-epi-prostaglandin F(2alpha).

Jpn Heart J. 2004 Mar;45(2):297-303.

Masuda A, Miyata M, Kihara T, Minagoe S, Tei C.

Abstract

We have reported that repeated sauna therapy improves impaired vascular endothelial function in a patient with coronary risk factors. We hypothesized that sauna therapy decreases urinary 8-epi-prostaglandin F(2alpha) (PGF(2alpha)) levels as a marker of oxidative stress and conducted a randomized, controlled study. Twenty-eight patients with at least one coronary risk factor were divided into a sauna group (n = 14) and non-sauna group (n = 14).

Sauna therapy was performed with a 60 degrees C far infrared-ray dry sauna for 15 minutes and then bed rest with a blanket for 30 minutes once a day for two weeks.

Systolic blood pressure and increased urinary 8-epi-PGF(2alpha) levels in the sauna group were significantly lower than those in the non-sauna group at two weeks after admission (110 +/- 15 mmHg vs 122 +/- 13 mmHg, P < 0.05, 230 +/- 67 pg/mg x creatinine vs 380 +/- 101 pg/mg x creatinine, P < 0.0001, respectively).

These results suggest that repeated sauna therapy may protect against oxidative stress, which leads to the prevention of atherosclerosis (Hardening of the Arteries).

3. Repeated (Far Infrared) thermal therapy improves impaired vascular endothelial function in patients with coronary risk factors.

J Am Coll Cardiol. 2001 Oct;38(4):1083-8.

Imamura M1, Biro S, Kihara T, Yoshifuku S, Takasaki K, Otsuji Y, Minagoe S, Toyama Y, Tei C.

Abstract

OBJECTIVES: We sought to determine whether sauna therapy, a thermal vasodilation therapy, improves endothelial function in patients with coronary risk factors such as hypercholesterolemia, hypertension, diabetes mellitus and smoking.

BACKGROUND: Exposure to heat is widely used as a traditional therapy in many different cultures. We have recently found that repeated sauna therapy improves endothelial and cardiac function in patients with chronic heart failure.

METHODS: Twenty-five men with at least one coronary risk factor (risk group: 38 +/- 7 years) and 10 healthy men without coronary risk factors (control group: 35 +/- 8 years) were enrolled. Patients in the risk group were treated with a 60 degrees C far infrared-ray dry sauna bath for 15 min and then kept in a bed covered with blankets for 30 min once a day for two weeks. To assess endothelial function, brachial artery diameter was measured at rest, during reactive hyperemia (flow-mediated endothelium-dependent dilation [%FMD]), again at rest and after sublingual nitroglycerin administration (endothelium-independent vasodilation [%NTG]) using high-resolution ultrasound.

RESULTS: The %FMD was significantly impaired in the risk group compared with the control group (4.0 +/- 1.7% vs. 8.2 +/- 2.7%, p < 0.0001), while %NTG was similar (18.7 +/- 4.2% vs. 20.4 +/- 5.1%). Two weeks of sauna therapy significantly improved %FMD in the risk group (4.0 +/- 1.7% to 5.8 +/- 1.3%, p < 0.001). In contrast, %NTG did not change after two weeks of sauna therapy (18.7 +/- 4.2% to 18.1 +/- 4.1%).

CONCLUSIONS:
Repeated sauna treatment improves impaired vascular endothelial function in the setting of coronary risk factors, suggesting a therapeutic role for sauna treatment in patients with risk factors for atherosclerosis.

Blocked Coronary Arteries – Chronic total Occlusion (CTO)

1. Repeated (Waon/Far Infrared) sauna therapy improves myocardial perfusion in patients with chronically occluded coronary artery-related ischemia.

Int J Cardiol. 2012 Jan 12. [Epub ahead of print]

Sobajima M, Nozawa T, Ihori H, Shida T, Ohori T, Suzuki T, Matsuki A, Yasumura S, Inoue H.

Source: The Second Department of Internal Medicine, Graduate School of Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan.

Abstract

BACKGROUND: Repeated low-temperature sauna (Waon/Far Infrared)therapyrelieves ischemic symptoms in patients with peripheral arterial disease. We investigated whether Waon (Far Infrared) therapy could improve myocardial perfusion in patients with ischemia related to chronic total occlusion (CTO) of coronary arteries.

METHODS: Twenty-four patients who had ischemia in the chronic total occlusion (CTO)-related area were examined. The severity of ischemia was quantified by thallium-201 myocardial perfusion scintigraphy with adenosine. The Waon (Far Infrared) group (n=16) was treated daily for three weeks with a 60°C far infrared-ray dry sauna bath for 15min and then kept in a bed covered with blankets for 30min. The control group (n=8) underwent myocardial perfusion scintigraphy twice with a three-week interval.

RESULTS: In the control group, neither summed stress score (SSS) nor summed difference score (SDS) of myocardial scintigraphy changed. However, Waon (Far Infrared) therapy improved both SSS (16±7 to 9±6, p<0.01) and SDS (7±4 to 3±2, p<0.01), and the improvement was greater in patients with higher SSS and SDS scores at the baseline. Waon (Far Infrared) therapy extended treadmill exercise time (430±185 to 511±192s, p<0.01) and improved flow-mediated dilation of the brachial artery (4.1±1.3 to 5.9±1.8%, p<0.05), but tended to decrease the number of circulating CD34-positive bone marrow-derived cells.

CONCLUSIONS:
Waon (Far Infrared) therapy improves chronic total occlusion (CTO) related myocardial ischemia in association with improvement of vascular endothelial function. This therapy could be a complementary and alternative tool in patients with severe coronary lesions not suitable for coronary intervention.