title: Acute effects of Finnish sauna and cold-water immersion on haemodynamic variables and autonomic nervous system activity in patients with heart failure.
abstract: BACKGROUND
  The haemodynamic response to Finnish sauna and subsequent cold-water immersion in heart failure patients is unknown.
  
  
  METHODS
  Haemodynamic response to two consecutive Finnish sauna (80℃) exposures, followed by a final head-out cold-water immersion (12℃) was measured in 37 male participants: chronic heart failure (n = 12, 61.8 ± 9.2 years), coronary artery disease (n = 13, 61.2 ± 10.6 years) and control subjects (n = 12, 60.9 ± 8.9 years). Cardiac output was measured non-invasively with an inert gas rebreathing method prior to and immediately after the first sauna exposure and after cold-water immersion, respectively. Blood pressure was measured before, twice during and after sauna. The autonomic nervous system was assessed by power spectral analysis of heart rate variability. Total power, low-frequency and high-frequency components were evaluated. The low frequency/high frequency ratio was used as a marker of sympathovagal balance. Sauna and cold-water immersion were well tolerated by all subjects.
  
  
  RESULTS
  Cardiac output and heart rate significantly increased in all groups after sauna and cold-water immersion (p < 0.05), except for coronary artery disease patients after sauna exposure. Systolic blood pressure during sauna decreased significantly in all groups with a nadir after 6 min (all p < 0.05). Cold-water immersion significantly increased systolic blood pressure in all groups (p < 0.05). No change in the low/high frequency ratio was found in chronic heart failure patients. In coronary artery disease patients and controls a prolonged increase in low frequency/high frequency ratio was observed after the first sauna exposure.
  
  
  CONCLUSIONS
  Acute exposure to Finnish sauna and cold-water immersion causes haemodynamic alterations in chronic heart failure patients similarly to control subjects and in particular did not provoke an excessive increase in adrenergic activity or complex arrhythmias.
authors.affiliation: Division of Cardiovascular Prevention, Rehabilitation and Sports Medicine, Department of Cardiology, Bern University Hospital and University of Bern, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Radtke
authors.affiliation: Division of Cardiovascular Prevention, Rehabilitation and Sports Medicine, Department of Cardiology, Bern University Hospital and University of Bern, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Poerschke
authors.affiliation: Division of Cardiovascular Prevention, Rehabilitation and Sports Medicine, Department of Cardiology, Bern University Hospital and University of Bern, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Wilhelm
authors.affiliation: Division of Cardiovascular Prevention, Rehabilitation and Sports Medicine, Department of Cardiology, Bern University Hospital and University of Bern, Switzerland.
authors.forename: Lukas D
authors.initials: LD
authors.lastname: Trachsel
authors.affiliation: Berner Reha Zentrum, Heiligenschwendi, Switzerland.
authors.forename: Hansueli
authors.initials: H
authors.lastname: Tschanz
authors.affiliation: Berner Reha Zentrum, Heiligenschwendi, Switzerland.
authors.forename: Friederike
authors.initials: F
authors.lastname: Matter
authors.affiliation: Division of Cardiovascular Prevention, Rehabilitation and Sports Medicine, Department of Cardiology, Bern University Hospital and University of Bern, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Jauslin
authors.affiliation: Division of Cardiovascular Prevention, Rehabilitation and Sports Medicine, Department of Cardiology, Bern University Hospital and University of Bern, Switzerland.
authors.forename: Hugo
authors.initials: H
authors.lastname: Saner
authors.affiliation: Division of Cardiovascular Prevention, Rehabilitation and Sports Medicine, Department of Cardiology, Bern University Hospital and University of Bern, Switzerland jean-paul.schmid@spitalnetzbern.ch.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Schmid
mesh_terms: D000368:Aged; D001794:Blood Pressure; D002302:Cardiac Output; D002908:Chronic Disease; D003080:Cold Temperature / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006321:Heart / Q000294:innervation*; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D007101:Immersion / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D029002:Steam Bath / Q000009:adverse effects; D013557:Switzerland; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D013997:Time Factors; D016896:Treatment Outcome; D014867:Water / Q000009:adverse effects
chemical_list: D014867:Water
keywords: Heat exposure; cardiac output; cold-water immersion; heart failure; sympathetic nervous system activity