Repeated sauna therapy improves myocardial perfusion in patients with chronically occluded coronary artery-related ischemia

article Background: Repeated low-temperature sauna (Waon) therapy relieves ischemic symptoms in patients with peripheral arterial disease. We investigated whether Waon therapy could improve myocardial perfusion in patients with ischemia related to chronic total occlusion (CTO) of coronary arteries. Methods: Twenty-four patients who had ischemia in the CTO-related area were examined. The severity of ische- mia was quantified by thallium-201 myocardial perfusion scintigraphy with adenosine. The Waon group (n=16) was treated daily for three weeks with a 60 °C far infrared-ray dry sauna bath for 15 min and then kept in a bed covered with blankets for 30 min. The control group (n=8) underwent myocardial perfusion scintigraphy twice with a three-week interval. Results: In the control group, neither summed stress score (SSS) nor summed difference score (SDS) of myocar- dial scintigraphy changed. However, Waon therapy improved both SSS (16±7 to 9±6, pb0.01) and SDS (7±4 to 3±2, pb0.01), and the improvement was greater in patients with higher SSS and SDS scores at the baseline. Waon therapy extended treadmill exercise time (430±185 to 511±192 s, pb0.01) and improved flow- mediated dilation of the brachial artery (4.1±1.3 to 5.9±1.8%, pb0.05), but tended to decrease the number of circulating CD34-positive bone marrow-derived cells. Conclusions: Waon therapy improves CTO-related myocardial ischemia in association with improvement of vascularendothelialfunction.Thistherapycouldbeacomplementaryandalternativetoolinpatientswithsevere coronary lesions not suitable for coronary intervention.