Search tips
Search criteria 


Logo of mayoclinprocLink to Publisher's site
Mayo Clin Proc. 2010 July; 85(7): 693.
PMCID: PMC2894726

Does Thermal Therapy Benefit Patients With Chronic Heart Failure?

To the Editor: The recent symposium by Ramani et al1 is a concisely written overview of the current management of chronic heart failure, surely to be of value to both the specialist and generalist. Absent from this review, however, is any mention of “Waon” or thermal therapy, likely in part because Waon therapy is not well known or appropriately used by most clinicians in the United States.

First described by Tei et al2 in 1995, the methodology of thermal therapy and its benefits for patients with chronic heart failure (CHF) have been detailed extensively in the literature.3-6 These studies demonstrate improved New York Heart Association classification, decreased heart size, improved cardiac function, lowered incidence of arrhythmias, reduced brain natriuretic peptide and norepinephrine levels, and improvement in endothelial function. Furthermore, although not germane to this article, additional benefits have been described for thermal therapy in several other diseases, including Sjögren syndrome, peripheral vascular disease, pulmonary hypertension, and fibromyalgia.

It is interesting to speculate about reasons for the failure to use this therapeutic modality in this country, including absence of any financial incentives, but clearly a deficiency in knowledge of Waon therapy plays an important role. A brief discussion of thermal therapy in CHF would have been appropriate in this symposium in Mayo Clinic Proceedings, especially because Tei's original research into this modality was done while he was an international fellow at Mayo Clinic.


1. Ramani GV, Uber PA, Mehra MR. Chronic heart failure: contemporary diagnosis and management. Mayo Clin Proc. 2010;85(2):180-195 [PMC free article] [PubMed]
2. Tei C, Horikiri Y, Park JC, et al. Acute hemodynamic improvement by thermal vasodilation in congestive heart failure. Circulation 1995;91(10):2582-2590 [PubMed]
3. Kihara T, Biro S, Ikeda Y, et al. Effects of repeated sauna treatment on ventricular arrhythmias in patients with chronic heart failure. Circ J. 2004;68(12):1146-1151 [PubMed]
4. Cider A, Sveälv BG, Täng MS, Schaufelberger M, Andersson B. Immersion in warm water induces improvement in cardiac function in patients with chronic heart failure. Eur J Heart Fail 2006;8(3):308-313 [PubMed]
5. Cider A, Schaufelberger M, Sunnerhagen KS, Andersson B. Hydrotherapy—a new approach to improve function in the older patient with chronic heart failure. Eur J Heart Fail 2003;5(4):527-535 [PubMed]
6. Kihara T, Biro S, Imamura M, et al. Repeated sauna treatment improves vascular endothelial and cardiac function in patients with chronic heart failure. J Am Coll Cardiol. 2002;39(5):754-759 [PubMed]

Articles from Mayo Clinic Proceedings are provided here courtesy of The Mayo Foundation for Medical Education and Research