Alarcon, Mikko Anthony P.

BSN406

A Warm Footbath Improves Coronary Flow Reserve

in Patients with Mild-to-Moderate Coronary Artery Disease

According to the article recent studies have shown that thermal therapy by means of
warm water baths and sauna has beneficial effects in chronic heart failure. However, a
comprehensive investigation of thehemodynamic effects of thermal vasodilation on
coronary arteries has not been previously undertaken. In this study, we studied the
effect of a warm footbath (WFB) on coronary arteries in patients with coronary artery
disease (CAD), as well as any adverse effect. The methods use are Study population,
Coronary Angiography , Electrocardiography and measurement of Coronary Doppler.
The purpose of this study was to investigate the effect of WFB on coronary flow after an
echocardiography and to detect any side effect in patients with CAD. Previous reports
showed an improvement in vascular endothelial function, exercise tolerance, quality of
life, and preload and afterload reduction in patients with CHF and pulmonary
hypertension with sauna and Waon therapy. However a comprehensive investigation of
the hemodynamic effects of thermal vasodilation of WFB on coronary arteries with
echocardiography had not previously been undertaken. Therefore, we investigated
whether the WFB can improve coronary flow and cause any adverse effects in patients
with CAD. When considering the potential use of thermal therapy as a therapeutic
modality, the safety of this practice can be controversial. Thermal therapy may be
considered as dangerous because it increases heart rate and cardiac output, potentially
leading to cardiac stress for people with heart disease and failure. However, although
heat does increase heart rate and cardiac output, it also has benefits in afterload
reduction from vasodilation and salt loss. Therefore, diastolic function and coronary flow
can benefit from this. In addition, NO was the main cause of endothelial functional
improvement in thermal therapy,and dilation of coronary artery also can be accentuated
by thermal therapy. A great deal of experience on thermal exposure with CAD came

from studies on Finnish saunas. This study has a few limitations. First is the small
sample size. Second is that coronary flow analysis and comparison in a normal control
was lacking. Third is that analysis in patients with more aggravated atherosclerosis and
ischemic heart disease was not performed. A WFB significantly improved CFR without
any adverse effect in patients with mild-to-moderate CAD. It can be helpful to patients
with CAD if appropriately performed.
Source:
http://content.ebscohost.com/pdf27_28/pdf/2011/GSE/01Nov11/67196031.pdf?
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