Clinical Investigation
Safety and Efficacy of Repeated Sauna Bathing in Patients With Chronic Systolic Heart Failure: A Preliminary Report

https://doi.org/10.1016/j.cardfail.2005.03.004Get rights and content

Abstract

Background

We sought to determine the safety and efficacy of repeated 60°C sauna bathing in patients with chronic systolic congestive heart failure (CHF).

Methods and Results

This study included 15 hospitalized CHF patients (New York Heart Association class = 2.8 ± 0.4) in stable clinical condition on conventional treatments. Sauna bathing was performed once per day for 4 weeks. Repeated sauna bathing was safely completed without any adverse effects in all patients. Symptoms improved in 13 of 15 patients after 4 weeks. Sauna bathing decreased systolic blood pressure without affecting heart rate, resulting in significant decrease in the rate-pressure product (6811 ± 1323 to 6292 ± 1093). Echocardiographic left ventricular ejection fraction was significantly increased from 30 ± 11 to 34 ± 11%. Sauna bathing significantly improved exercise tolerance manifested by prolonged 6-minute walking distance (388 ± 110 to 448 ± 118 m), increased peak respiratory oxygen uptake (13.3 ± 1.8 to 16.3 ± 2.1 mL/kg/min), and enhanced anaerobic threshold (9.4 ± 1.2 to 11.5 ± 1.9 mL/kg/min). Four-week bathing significantly reduced plasma epinephrine (40 ± 42 to 21 ± 23 pg/mL) and norepinephrine (633 ± 285 to 443 ± 292 pg/mL). Sauna bathing reduced the number of hospital admission for CHF (2.5 ± 1.3 to 0.6 ± 0.8 per year).

Conclusion

Repeated 60°C sauna bathing was safe and improved symptoms and exercise tolerance in chronic CHF patients. Sauna bathing may be an effective adjunctive therapy for chronic systolic CHF.

Section snippets

Methods

This study included 15 (12 men and 3 women) patients with chronic CHF (Table 1); 6 with idiopathic dilated cardiomyopathy, 1 with dilated phase of hypertrophic cardiomyopathy, 7 with old myocardial infarction, and 1 with valvular heart disease. Age of the patients ranged from 34 to 75 (mean 62 ± 15) years. Of these patients, 3 and 12 were in New York Heart Association (NYHA) functional class II and III, respectively. This study excluded patients with (1) acute myocardial infarction or unstable

Results

All patients enrolled in this study completed 4-week repeated sauna bathing without any adverse symptoms and events. Of 12 patients with NYHA functional class III, 3 improved to functional class II (Fig. 1). As shown in Table 2, the self-assessment quality-of-life questionnaire revealed that 13 of 15 patients were categorized as the improved group. Improvements of shortness of breath and fatigue were most evident. Body weight did not change (Table 3). Repeated sauna bathing decreased systemic

Discussion

The present study demonstrated for the first time that repeated 60°C sauna bathing for 4 weeks improved exercise tolerance and clinical symptoms in patients with chronic systolic CHF on conventional treatments. Moreover, LVEF was improved, and elevated plasma epinephrine and norepinephrine were decreased. No apparent adverse events were experienced. During the follow-up, sauna bathing reduced the number of hospital admission for CHF.

Most of patients were subjectively in NYHA functional class

Conclusions

Repeated 60°C sauna bathing for 4 weeks improved not only well-being but also exercise tolerance in chronic systolic CHF patients on conventional treatments. It is suggested that repeated sauna bathing is a safe and effective adjunctive therapy for chronic CHF.

References (16)

  • M.A. Pfeffer et al.

    Effects of candesartan on mortality and morbidity in patients with chronic heart failure: the CHARM-Overall programme

    Lancet

    (2003)
  • T. Kihara et al.

    Repeated sauna treatment improves vascular endothelial and cardiac function in patients with chronic heart failure

    J Am Coll Cardiol

    (2002)
  • The SOLVD Investigators

    Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure

    N Engl J Med

    (1991)
  • The SOLVD Investigators

    Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions

    N Engl J Med

    (1992)
  • J.N. Cohn et al.

    Valsartan Heart Failure Trial Investigators. A randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure

    N Engl J Med

    (2001)
  • M. Packer et al.

    The effect of carvedilol on morbidity and mortality in patients with chronic heart failure

    N Engl J Med

    (1996)
  • M. Packer et al.

    Effects of carvedilol on survival in severe chronic heart failure

    N Eng J Med

    (2001)
  • B. Pitt et al.

    The effect of spironolactone on morbidity and mortality in patients with severe heart failure

    N Engl J Med

    (1999)
There are more references available in the full text version of this article.

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Partially supported and by a Grant-in-Aid for Scientific Research and by a grant for Academic Frontier Project from the Ministry of Education, Science, Sports, Culture, and Technology, Japan.

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