title: Repeated sauna treatment improves vascular endothelial and cardiac function in patients with chronic heart failure.
abstract: OBJECTIVE
  The purpose of this study was to determine the mechanism by which 60 degrees C sauna treatment improves cardiac function in patients with chronic heart failure (CHF).
  
  
  BACKGROUND
  We have previously reported that repeated 60 degrees C sauna treatment improves hemodynamic data and clinical symptoms in patients with CHF. We hypothesized that the sauna restores endothelial function and then improves cardiac function.
  
  
  METHODS
  Twenty patients (62 plus minus 15 years) in New York Heart Association (NYHA) functional class II or III CHF were treated in a dry sauna at 60 degrees C for 15 min and then kept on bed rest with a blanket for 30 min, daily for two weeks. Ten patients with CHF, matched for age, gender and NYHA functional class, were placed on a bed in a temperature-controlled (24 degrees C) room for 45 min as the nontreated group. Using high-resolution ultrasound, we measured the diameter of the brachial artery at rest and during reactive hyperemia (percent flow-mediated dilation, %FMD: endothelium-dependent dilation), as well as after sublingual administration of nitroglycerin (%NTG: endothelium-independent dilation). Cardiac function was evaluated by measuring the concentrations of plasma brain natriuretic peptide (BNP).
  
  
  RESULTS
  Clinical symptoms were improved in 17 of 20 patients after two weeks of sauna therapy. The %FMD after two-week sauna treatment significantly increased from the baseline value, whereas the %NTG-induced dilation did not. Concentrations of BNP after the two-week sauna treatment decreased significantly. In addition, there was a significant correlation between the change in %FMD and the percent improvement in BNP concentrations in the sauna-treated group. In contrast, none of the variables changed at the two-week interval in the nontreated group.
  
  
  CONCLUSIONS
  Repeated sauna treatment improves vascular endothelial function, resulting in an improvement in cardiac function and clinical symptoms.
authors.affiliation: First Department of Internal Medicine, Faculty of Medicine, Kagoshima University, Kagoshima, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kihara
authors.forename: Sadatoshi
authors.initials: S
authors.lastname: Biro
authors.forename: Masakazu
authors.initials: M
authors.lastname: Imamura
authors.forename: Shiro
authors.initials: S
authors.lastname: Yoshifuku
authors.forename: Kunitsugu
authors.initials: K
authors.lastname: Takasaki
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Otuji
authors.forename: Shinichi
authors.initials: S
authors.lastname: Minagoe
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Toyama
authors.forename: Chuwa
authors.initials: C
authors.lastname: Tei
mesh_terms: D000328:Adult; D000368:Aged; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D002302:Cardiac Output / Q000502:physiology*; D002908:Chronic Disease; D003326:Coronary Circulation / Q000502:physiology; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019233:Retreatment; D012720:Severity of Illness Index; D029002:Steam Bath; D014463:Ultrasonography