2012 年 51 巻 17 号 p. 2263-2270
Background Systemic thermal therapy (STT) has been associated with beneficial effects in patients with chronic heart failure (CHF). The fact, however, that it requires a dedicated as well as spacious facility and trained personnel makes it difficult to practice in the daily care of patients with CHF.
Objective The aim of this study was to determine whether the leg thermal therapy (LTT) has a positive impact similar to that of STT in patients with CHF.
Methods and Results Twenty patients with CHF (57±17 years old, left ventricular ejection fraction=30±10%) received LTT (45°C) for 20 minutes. Immediately after the treatment, the core temperature had increased (+0.3±0.3°C) (p<0.01). While the LTT had no significant effects on the heart rate, systolic arterial pressure, and diastolic blood pressure, it increased the cardiac output (mixed venous oxygen saturation; +2±3%) and decrease the pulmonary capillary wedge pressure (-2±2 mmHg). The LTT significantly improved the flow-mediated vasodilatation (FMD) from 4.8±2.6 to 7.1±3.6%, the antioxidative markers, thiol from 4.0±0.7 to 4.5±0.9 μmoL/g, and the marker of oxidative deoxyribonucleic acid (DNA) damage, urine 8-hydroxy-2'deoxyguanosine (8OHdG) from 100 to 82±3%, respectively (p<0.05). No patient had any adverse effects associated with LTT.
Conclusion LTT acutely improved FMD, and oxidative stress in patients with CHF. Although the long-term effect of LTT remains to be investigated, its practicality which is comparable to that of STT would make it an attractive therapeutic strategy for patients with CHF.