title: Experience of appendicular thermal therapy applied to a patient with a left ventricular assist device awaiting heart transplantation.
abstract: Thermal therapy for heart failure is recognized to improve clinical symptoms. We describe our experience with appendicular thermal therapy applied to a patient fitted with an extracorporeal left ventricular assist device (LVAD) who was wait-listed for a heart transplant. A 21-year-old male with end-stage heart failure due to dilated cardiomyopathy was fitted with a LVAD. His general condition stabilized after LVAD placement and the status of his heart failure has remained at NYHA class II for the past 13 months. However, his cardiac function did not sufficiently recover to discontinue LVAD support. We conducted appendicular thermal therapy using a steam foot bath and heated gloves for 2 weeks. Immediately after thermal therapy, his average sublingual temperature increased from 36.3 to 37.0 degrees C and the grade of mitral regurgitation, as well as LV ejection fraction and endothelial function improved. Furthermore, levels of oxidative and anti-oxidative stress markers decreased and increased, respectively, after 2 weeks of therapy. No complications developed. We conclude that appendicular thermal therapy was safe in this patient waiting for a heart transplant and who had an extracorporeal LVAD, and that the procedure might be beneficial for others with end-stage heart failure.
authors.affiliation: Division of Cardiology, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita-shi, Osaka 565-8565, Japan.
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Higashi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Komamura
authors.forename: Noboru
authors.initials: N
authors.lastname: Oda
authors.forename: Tomoko S
authors.initials: TS
authors.lastname: Kato
authors.forename: Masanobu
authors.initials: M
authors.lastname: Yanase
authors.forename: Akiko
authors.initials: A
authors.lastname: Mano
authors.forename: Shuji
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Wada
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Shishido
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Hashimura
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kitakaze
authors.forename: Soichiro
authors.initials: S
authors.lastname: Kitamura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakatani
mesh_terms: D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000628:therapy; D005528:Foot; D006225:Hand; D006333:Heart Failure / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006358:Hot Temperature / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D029002:Steam Bath; D014850:Waiting Lists