title: Neurohumoral Modulation During Waon Therapy in Chronic Heart Failure　- Subanalysis of Waon-CHF Study.
abstract: Heart failure (HF) is a disease of neurohumoral dysfunction and current pharmacological therapies for HF have not improved mortality rates, thus requiring additional new strategies. Waon therapy for HF patients may be a complementary strategy with peripheral vasodilation via nitric oxide. We hypothesized that Waon therapy would improve neurohumoral factors, such as natriuretic peptides (NP) and the renin-angiotensin-aldosterone system (RAAS) in HF.
  
  
  
  Plasma samples were collected from patients enrolled in the WAON-CHF Study (Waon therapy (n=77) or control (n=73)) before and after the treatment. B-type NP (BNP), C-type NP (CNP), and aldosterone (Aldo) levels were measured by respective specific radioimmunoassays. Although clinical parameters significantly improved in the Waon group compared with the control group, BNP, Aldo, and CNP levels were not statistically different between groups. On subanalysis with patient variables, BNP levels were improved in the Waon group treated with angiotensin-converting enzyme inhibitor/angiotensin-receptor blocker or spironolactone. In addition, Aldo levels were improved in the Waon group patients with diabetes mellitus, hypertension, and inotrope use, and CNP levels were improved in Waon group patients with estimated glomerular filtration rate <60 mL/min/1.73 m2. These changes were not observed in the control group.
  
  
  
  Waon therapy may accelerate the favorable actions of RAAS modulators in HF. (WAON-CHF Study: UMIN000006705).
authors.affiliation: Cardiorenal Research Laboratory, Department of Cardiovascular Diseases, Mayo Clinic.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Ichiki
authors.affiliation: Cardiorenal Research Laboratory, Department of Cardiovascular Diseases, Mayo Clinic.
authors.forename: John C
authors.initials: JC
authors.lastname: Burnett
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Scott
authors.affiliation: Cardiorenal Research Laboratory, Department of Cardiovascular Diseases, Mayo Clinic.
authors.forename: Denise M
authors.initials: DM
authors.lastname: Heublein
authors.affiliation: Department of Cardiovascular Medicine and Hypertension, Kagoshima University Hospital.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Miyata
authors.affiliation: Internal Medicine II, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kinugawa
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University.
authors.forename: Teruo
authors.initials: T
authors.lastname: Inoue
authors.affiliation: Department of Cardiovascular Medicine, Dokkyo Medical University.|Waon Therapy Research Institute.
authors.forename: Chuwa
authors.initials: C
authors.lastname: Tei
mesh_terms: D000450:Aldosterone / Q000097:blood; D016022:Case-Control Studies; D002908:Chronic Disease; D000529:Complementary Therapies / Q000379:methods*; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood; D020098:Natriuretic Peptide, C-Type / Q000097:blood; D012084:Renin-Angiotensin System
chemical_list: D020097:Natriuretic Peptide, Brain; D020098:Natriuretic Peptide, C-Type; D000450:Aldosterone
keywords: Heart failure; Natriuretic peptides; Renin-angiotensin-aldosterone system; Waon therapy