Diagnostic Value of the Padua Score Combined with Thrombotic Biomarker Tissue Plasminogen Activator Inhibitor-1 (tPAI-1) Detection for the Risk of Deep Vein Thrombosis in Patients with Pulmonary Heart Disease

This study explores the diagnostic value of combining the Padua score with the thrombotic biomarker tissue plasminogen activator inhibitor-1(tPAI-1)for assessing the risk of deep vein thrombosis(DVT)in patients with pulmonary heart disease.These patients often exhibit symptoms similar to venous thrombosis,such as dyspnea and bilateral lower limb swelling,complicating differential diagnosis.The Padua Prediction Score assesses the risk of venous thromboembolism(VTE)in hospitalized patients,while tPAI-1,a key fibrinolytic system inhibitor,indicates a hypercoagulable state.Clinical data from hospitalized patients with cor pulmonale were retrospectively analyzed.ROC curves compared the diagnostic value of the Padua score,tPAI-1 levels,and their combined model for predicting DVT risk.Results showed that tPAI-1 levels were significantly higher in DVT patients compared to non-DVT patients.The Padua score demonstrated a sensitivity of 82.61%and a specificity of 55.26%at a cutoff value of 3.The combined model had a significantly higher AUC than the Padua score alone,indicating better discriminatory ability in diagnosing DVT risk.The combination of the Padua score and tPAI-1 detection significantly improves the accuracy of diagnosing DVT risk in patients with pulmonary heart disease,reducing missed and incorrect diagnoses.This study provides a comprehensive assessment tool for clinicians,enhancing the diagnosis and treatment of patients with cor pulmonale complicated by DVT.Future research should validate these findings in larger samples and explore additional thrombotic biomarkers to optimize the predictive model.

Effectiveness of cognitive behavioral therapy-based interventions on health outcomes in patients with coronary heart disease:A metaanalysis

BACKGROUND Recently,the efficacy of cognitive behavioral therapy(CBT)-based intervention on health outcomes in patients with coronary heart disease(CHD)has been recognized in randomized controlled trials(RCTs),but no comprehensive systematic review has been conducted.To address this research gap,our study aimed to evaluate whether comprehensive CBT-based interventions positively affect health outcomes in CHD patients.It was hypothesized that CBT-based interventions are effective in:(1)Reducing depression,anxiety,and stress symptoms;(2)Reducing body mass index,blood pressure,and lipid levels;and(3)Improving quality of life,and exercise endurance.AIM To verify the effectiveness of CBT-based interventions on CHD patients through a meta-analysis of previous publications.METHODS Relevant RCTs published in English were obtained by searching electronic databases,including PubMed,Embase,Cochrane Central Register of Controlled Trials,Scopus,and Proquest,with the retrieval time from inception to August 2020.The primary outcomes were psychological factors(depression,anxiety,and stress symptoms),physiological factors(body mass index,blood pressure,blood lipids).The secondary outcomes included quality of life and exercise endurance.We used Review Manager 5.3 to conduct the meta-analysis and used the Physiotherapy Evidence Database tool to evaluate the quality of studies.RESULTS A total of 22 RCTs comprising 4991 patients with CHD were included in the systematic review and meta-analysis.The main analysis revealed that CBT-based intervention can reduce depression symptoms:-2.00[95%confidence interval(CI):-2.83 to-1.16,P<0.001];anxiety symptoms:-2.07(95%CI:-3.39 to-0.75,P=0.002);stress symptoms:-3.33(95%CI:-4.23 to-2.44,P<0.001);body mass index:-0.47(95%CI:-0.81 to-0.13,P=0.006);and improve physical functioning:3.36(95%CI:1.63 to 5.10,P=0.000)and mental functioning:6.91(95%CI:4.10 to 9.73,P<0.001).Moreover,subgroup analysis results showed that CBT-based interventions were more effective for symptoms of depression and anxiety in CHD patients when individual,as opposed to group treatment,and psycho-education,behavioral and cognitive strategies were applied as the core treatment approaches.CONCLUSION CBT-based interventions are effective treatment strategies for CHD patients,significantly improving their symptoms of depression,anxiety and stress,body mass index,and health-related quality of life.

Moving forward on the pathway of cell-based therapies in ischemic heart disease and heart failure-time for new recommendations?

Although substantial advances have been made in treating ischemic heart disease and subsequent heart failure, the overall morbidity and mortality from these conditions remain high. Stem cell-based therapy has emerged as a promising approach for prompting cardiac rejuvenation. Various cell types have been tested in the clinical arena, proving consistent safety results. As for efficiency outcomes, contradictory findings have been reported, partly due to inconsistency in study protocols but also due to poor survival, engraftment and differentiation of transplanted cells in the hostile milieu of the ischemic host tissue. Studies have varied in terms of route of delivery, type and dose of implanted stem cells, patient selection and randomization, and assessment of therapeutic effect. Founded on the main achievements and challenges within almost 20 years of research, a number of official documents have been published by leading experts in the field. Core recommendations have focused on developing and optimizing effective strategies to enrich cell retention and their regenerative potential. Issued consensus and position papers have stemmed from an unmet need to provide a harmonized framework for future research, resulting in improved therapeutic application of cell-based therapies for cardiac regeneration and repair.

Therapies for patients with coexisting heart failure with reduced ejection fraction and non-alcoholic fatty liver disease

Heart failure with reduced ejection fraction(HFrEF)and nonalcoholic fatty liver disease(NAFLD)are two common comorbidities that share similar pathophysiological mechanisms.There is a growing interest in the potential of targeted therapies to improve outcomes in patients with coexisting HFrEF and NAFLD.This manuscript reviews current and potential therapies for patients with coexisting HFrEF and NAFLD.Pharmacological therapies,including angiotensinconverting enzyme inhibitors/angiotensin receptor blockers,mineralocorticoids receptor antagonist,and sodium-glucose cotransporter-2 inhibitors,have been shown to reduce fibrosis and fat deposits in the liver.However,there are currently no data showing the beneficial effects of sacubitril/valsartan,ivabradine,hydralazine,isosorbide nitrates,digoxin,or beta blockers on NAFLD in patients with HFrEF.This study highlights the importance of considering HFrEF and NAFLD when developing treatment plans for patients with these comorbidities.Further research is needed in patients with coexisting HFrEF and NAFLD,with an emphasis on novel therapies and the importance of a multidisciplinary approach for managing these complex comorbidities.

The Effect of EDTA Chelation Therapy in Symptomatic Coronary Heart Disease: An Observational Study

Ethylene Diamine Tetra Acetic Acid (EDTA) chelation therapy has been considered a definitive alternative therapy for by-pass surgery in atherosclerotic cardiovascular disease for more than four decades. It is a relatively inexpensive method believed to restore blood flow in atherosclerotic vessels. However, the benefits of chelation therapy yet remain controversial in the treatment of ischemic heart disease. We observed the effect of EDTA chelation therapy on exercise tolerance in 13 volunteering patients receiving conventional treatment for established symptomatic coronary heart disease. Each patient received 30 weekly infusions of EDTA followed by monthly 12 boosters according to the ACAM protocol (American College for Advancement in Medicine). This was in addition to the conventional therapies they received from their respective physician in hospital. Stress ECG, echocardiography and coronary angiogram findings were obtained at the beginning of treatment. The distance that a patient could walk on level ground at moderate speed and the number of steps he/she can climb up on a staircase until he/she begins to feel either chest pain or breathlessness were the two clinical parameters of exercise tolerance recorded to grade angina. Liver and renal functions were tested at 1st, 5th, 10th, 15th and 30th infusions. Of the 13 patients, 11 showed improvement in angina grading whilst 2 experienced no effect. One patient improved from angina grade IV to I, 6 from grade III to I, 1 from grade III to II and 3 from grade II to I. A statistically significant reduction in the mean score (p = 0.002) was noticed at 6th month of treatment when compared to that of the first month. A significant 1.7 fold increase (p = 0.009) in the mean SGPT level was observed at the 30th infusion when compared to the pre-treatment values. The SGOT level showed no significant change (p = 0.664). None of the patients showed clinical features of hepato-cellular damage. The mean serum creatinine level showed a trend for reduction (p = 0.083) with treatment. The recognized side effects of intravenous EDTA chelation therapy such as liver damage, renal damage, hypersensitivity, symptomatic hypocalcaemia, and thrombophlebitis were not encountered. Thus, EDTA chelation therapy as prescribed by the ACAM protocol seems safe and effective in improving exercise tolerance in ischemic heart disease when administered concurrently with conventional therapy.

Application progress of cognitive behavioral therapy in coronary heart disease

To As one of the most common cardiovascular diseases,coronary heart disease has a high morbidity and mortality.In recent years,non-drug therapy has been put on equal importance with drug therapy due to its simple operation and fast onset.Cognitive behavioral therapy,as a kind of non-drug therapy,has been widely used to improve the physical and mental symptoms of patients with coronary heart disease.This article reviews the origin,concept,theoretical basis,characteristics,technology,and current research status of cognitive behavioral therapy in patients with coronary heart disease,in order to provide a reference for the clinical development of cognitive behavioral therapy.

Review of Medical Treatment of Stable Ischemic Heart Disease

Medical treatment is the initial treatment strategy and is the cornerstone of management in patients with stable ischemic heart disease (IHD). Many patients are not suitable for percutaneous or surgical revascularization because of unfavourable anatomy, or the presence of co-morbidities. In addition, many patients have recurrence of angina following revascularization due to restenosis or incomplete revascularization. Furthermore, randomized clinical trials comparing optimal medical treatment to revascularization have not clearly shown that myocardial revascularization is superior to optimal medical treatment. Traditional drugs for angina treatment include b-blockers, calcium channel blockers and nitrates. Newer drugs are available with different mechanisms of action and with equal efficacy that do not cause significant hemodynamic deterioration. The availability of these newer drugs expands the therapeutic potential of medical treatment to even a wider population with stable IHD. Revascularization in patients with stable ischemic heart disease has never been shown to reduce hard endpoints (death or myocardial infarction) in randomized clinical trials.

Design of a Biomedical Device to Reduce Anxiety Experienced by Patients Diagnosed with Parkinson’s Disease

Parkinson’s disease (PD) is a neurodegenerative disease that occurs due to loss of nerve cells that produce dopamine in the brain, affecting approximately 4 million people worldwide. PD patients often feel an increase in anxiety levels daily. While there are medications/exercises to help relieve anxiety, there are limited methods to reduce anxiety without the help of a caretaker. As a result, MEDIC Foundation, a non-profit organization in British Columbia, Canada, is designing an automated system that consists of a wristband and an application which uses vi-bration therapy to help reduce anxiety of PD patients. Literature reviews were conducted to document the project’s needs. Phase I of the project focused on de-veloping a prototype for the application and phase II on developing the wrist-band. The team developed prototypes of a wristband that automatically applies vibration near the median nerve as the heart rate variability (HRV) deviates away from the normal threshold of the user, and an application that displays real-time heart rate variability signals as well as provides for relaxation. The development of the prototype is still in early progress. By creating this automated system, we aim to provide a solution to senior PD patients to relieve anxiety independently. .

ACUPUNCTURE TREATMENT OF CORONARY HEART DISEASE

In the present study, the author adopted acupuncture therapy to treat 300 cases ofcoronary heart disease by needling Dahzhong (CV 17 )-to-Jiuwei (CV 15 ), Juque(CV 14 ), Neiguan(PC 6), Zusanli (ST 36), Xinshu (BL 15 ), Jueyinshu (BL 14), etc. and adopting tonification manipulation. Results showed that after treatment, of the 300 cases, 204 (68. 0% ) experienced significant improvement and 84 (28. 0 % ) had improvement, the total effective rate was 96 %. In 201 patients with ischemic ECG, 57 (28. 4% ) had marked amelioration, 93 (46. 2% ) had amelioration, 39(19. 4 % ) had no any apparent change and 12 (6. 0 % ) worsened, with an effective rate of 74. 6 %.Ultrasound cardiogram examination displayed that after acupuncture treatment, the amplitude of vibration of the back wall and the output of the left ventricle increased significantly, the nail fold microcirculation was bettered, and the blood viscosity and the vascular resistance a1l lowered.

Contemporary Management of Patients with Stable Ischemic Heart Disease

The overall goals of therapy for patients with stable ischemic heart disease are to minimize the likelihood of death while maximizing health and function.Initial risk assessment with noninvasive testing is indicated to determine whether invasive evaluation is needed in addition to medical therapy.All patients with stable ischemic heart disease need optimal medical therapy,which includes risk factor management with lifestyle modifi cations and pharmacologic therapy.First-line pharmacologic therapy is focused on preventing myocardial infarction and death with antiplatelet agents,lipid-lowering therapy,and antihypertensive therapies.In addition,antianginal therapy and anti-ischemic therapy are indicated to alleviate symptoms,reduce ischemia,and improve quality of life.The commonly used antianginal agents include nitrates,beta-blockers,calcium channel blockers,and ranolazine.When medical therapy is not adequate to relieve angina,revascularization with percutaneous coronary intervention or coronary artery bypass grafting is indicated.We review the indications and evidence for antianginal agents and other therapies for angina.

Heart failure as an adverse effect of infliximab for Crohn's disease: A case report and review of the literature

BACKGROUND Anti-tumor necrosis factor agents were the first biologic therapy approved for the management of Crohn's disease(CD).Heart failure(HF)is a rare but potential adverse effect of these medications.The objective of this report is to describe a patient with CD who developed HF after the use of infliximab.CASE SUMMARY A 50-year-old woman with a history of hypertension and diabetes presented with abdominal pain,diarrhea,and weight loss.Colonoscopy and enterotomography showed ulcerations,areas of stenosis and dilation in the terminal ileum,and thickening of the intestinal wall.The patient underwent ileocolectomy and the surgical specimen confirmed the diagnosis of stenosing CD.The patient started infliximab and azathioprine treatment to prevent post-surgical recurrence.At 6 mo after initiating infliximab therapy,the patient complained of dyspnea,orthopnea,and paroxysmal nocturnal dyspnea that gradually worsened.Echocardiography revealed biventricular dysfunction,moderate cardiac insufficiency,an ejection fraction of 36%,and moderate pericardial effusion,consistent with HF.The cardiac disease was considered an infliximab adverse effect and the drug was discontinued.The patient received treatment with diuretics for HF and showed improvement of symptoms and cardiac function.Currently,the patient is using anti-interleukin for CD and is asymptomatic.CONCLUSION This reported case supports the need to investigate risk factors for HF in inflammatory bowel disease patients and to consider the risk-benefit of introducing infliximab therapy in such patients presenting with HF risk factors.

One Case of Diabetes Nephropathy Stage V, Combined Valvular Disease, Total Heart Failure with Diabetes Foot Gangrene

The patient was found to have 4+urine sugar by physical examination 14 years ago and was treated with oral hypoglycemic drugs. Insulin was injected intramuscularly nine years ago. Two and a half years ago, it was found that the color of the thumb, index and middle toe of the left foot became black. He went to a third-class hospital in Beijing and was diagnosed as “diabetes foot”. He was treated with “balloon dilation of lower limb blood vessels of diabetes foot”. Half a year ago, the third toe on the right side was broken and treated in the hospital again. “Popliteal artery stent implantation” was given for the diagnosis of “double kidney insufficiency, diabetes foot, left heart failure, combined heart valve disease”, “Hemofiltration therapy” and anti-inflammatory, amino acid supplementation, kidney function protection, anticoagulation, anemia correction and other treatments. Later, he went to our hospital and was diagnosed by the TCM diagnosis: category of consumptive disease, toe or finger gangrene (syndrome/pattern of qi and yin deficiency). Western medicine diagnosed: stage V of diabetes nephropathy, type II diabetes foot gangrene, combined with heart valve disease, hypoalbuminemia, double kidney cyst, moderate anemia, pleural effusion, hyperkalemia, pulmonary infection, and total heart failure. The patient was treated by the Qi-acupuncture therapy of TCM in combination with Chinese and Western medicine Medical treatment made the patient significantly better and discharged.

Historical Evolution of the Anticoagulant-Antiplatelet Therapy in Patients with Mitral Valve Disease Associated to Atrial Fibrillation or Mechanical Valve Prosthesis. Role of Omeprazole

In this review article we analyze the historical evolution of anticoagulant and antiplatelet therapies in the treatment of atrial fibrillation plus complicated heart diseases. Its combined use, compared with anticoagulation alone, has been widely used to significantly reduce thromboembolic risk. Major bleeding risk has been usually registered during combined antithrombotic therapy, which is mainly due to gastric bleeding, but enteric coating antiplatelet tablets can effectively protect against gastric mucosal damage, and the addition of proton-pump inhibitors (omeprazole) can avoid it.

Effects of Ticagrelor on oxidative stress, coagulation function, platelet function and related factors in patients with coronary artery disease undergoing interventional therapy

Objective: To explore the effects of Ticagrelor on oxidative stress, coagulation function, platelet function and related factors in patients with coronary artery disease undergoing interventional therapy. Methods: A total of 140 patients with coronary artery disease who underwent percutaneous coronary intervention in our hospital from October 2016 to March 2018 were selected as the study subjects and were divided into control group (70 cases) and observation group (70 cases) by drawing lots. Both groups were treated with symptomatic routine therapy before operation. On this basis, the control group was treated with clopidogrel before operation, and the observation group was treated with Ticagrelor before operation on the basis of routine treatment. The changes of oxidative stress, coagulation index, platelet function and related factors were compared between the two groups before and after treatment. Results: Before treatment, there were no significant differences in oxidative stress factors, coagulation parameters, platelet parameters and related factors factors between the two groups. After treatment, the levels of MDA, MPAR, VEGF and MMP-9 in the two groups were lower than those before treatment, while the levels of SOD, APTT, TT and PT were higher than those before treatment;and the levels of MDA, MPAR, VEGF, MMP-9, APTT and PT in the observation group were significantly lower than those in the control group after treatment, while the levels fo SOD, TT and IPA in the observation group were significantly higher than those in the control group. Conclusions: Ticagrelor can better reduce oxidative stress injury, improve coagulation function and coronary stenosis, and inhibit platelet aggregation in patients with coronary heart disease undergoing PCI than clopidogrel. It has clinical popularization significance.

Testosterone and cardiovascular disease in men

Despite regional variations in the prevalence of coronary artery disease （CAD）, men are consistently more at risk of developing and dying from CAD than women, and the gender-specific effects of sex hormones are implicated in this inequality. This ＇Perspectives＇ article reviews the current evidence regarding the cardiovascular effects of testosterone in men including an examination of the age-related decline in testosterone, the relationship between testosterone levels and coronary disease, coronary risk factors and mortality. We also review the vaso-active effects of testosterone, and discuss how these have been used in men with heart failure and angina. We discuss the ＇cause＇ versus ＇effect＇ controversy, regarding low testosterone levels in men with coronary heart disease, as well as concerns over the use of testosterone replacement therapy in middle aged and elderly men. The article concludes with a discussion regarding the future direction for work in this interesting area, including the relative merits of screening for, and treating hypogonadism with testosterone replacement therapy in men with heart disease.

Andropause and the development of cardiovascular disease presentationmore than an epi-phenomenon

Andropause refers to a generalized decline of male hormones, including testosterone and dehydroepiandrosterone in middle-aged and aging men. This decline in hormones has been associated with changes such as depression, loss of libido, sexual dysfunction, and changes in body composition. Aging has been associated with an abundance of concomitant diseases, in particular cardiovascular diseases, and although andropause is correlated to aging, a causal relationship between reduction of androgens and the development of chronic diseases such as atherosclerosis and heart failure has not been convincingly established yet. On the other hand, increasing data has emerged that revealed the effects of low levels of androgens on cardiovascular disease progression. As an example, low levels of testosterone have been linked to a higher incidence of coronary artery disease. Whether hormone replacement therapy that is used for andropausal men to alleviate symptoms of ＂male menopause＂ can halt progression of cardiovascular disease, remains controversially discussed, primarily due to the lack of well-designed, randomized controlled trials. At least for symptom improvement, the use of androgen replacement therapy in andropausal men may be clinically indicated, and with the appropriate supervision and follow up may prove to be beneficial with regard to preservation of the integrity of cardiovascular health at higher ages.

Clinical management of inflammatory bowel disease in the organ recipient

There was estimated a higher incidence of de novo inflammatory bowel disease (IBD) after solid organ transplantation than in the general population. The onset of IBD in the organ transplant recipient population is an important clinical situation which is associated to higher morbidity and difficulty in the medical therapeutic management because of possible interaction between anti-reject therapy and IBD therapy. IBD course after liver transplantation (LT) is variable, but about one third of patients may worsen, needing an increase in medical therapy or a colectomy. Active IBD at the time of LT, discontinuation of 5-aminosalicylic acid or azathioprine at the time of LT and use of tacrolimus-based immunosuppression may be associated with an unfavorable outcome of IBD after LT. Anti-tumor necrosis factor alpha (TNF&#x003b1;) therapy for refractory IBD may be an effective and safe therapeutic option after LT. The little experience of the use of biological therapy in transplanted patients, with concomitant anti-rejection therapy, suggests there be a higher more careful surveillance regarding the risk of infectious diseases, autoimmune diseases, and neoplasms. An increased risk of colorectal cancer (CRC) is present also after LT in IBD patients with primary sclerosing cholangitis (PSC). An annual program of endoscopic surveillance with serial biopsies for CRC is recommended. A prophylactic colectomy in selected IBD/PSC patients with CRC risk factors could be a good management strategy in the CRC prevention, but it is used infrequently in the majority of LT centers. About 30% of patients develop multiple IBD recurrence and 20% of patients require a colectomy after renal transplantation. Like in the liver transplantation, anti-TNF&#x003b1; therapy could be an effective treatment in IBD patients with conventional refractory therapy after renal or heart transplantation. A large number of patients are needed to confirm the preliminary observations. Regarding the higher clinical complexity of this subgroup of IBD patients, a close multidisciplinary approach between an IBD dedicated gastroenterologist and surgeon and an organ transplantation specialist is necessary in order to have the best clinical management of IBD after transplantation.

Advances in radiation-induced heart disease diagnosis and treatment

Over the past decades,the survival rates of patients with cancer have significantly increased owing to advancements in cancer treatment strategies.Radiotherapy has become an indispensable treatment modality for thoracic tumors.While it offers benefits in treating or even potentially curing cancer,thoracic radiotherapy exposes neighboring heart tissues to ionizing radiation,elevating the risk of radiation-induced heart disease(RIHD).Despite improvements in radiotherapy techniques that have reduced the incidence of RIHD,complete avoidance of heart radiation exposure remains a challenge.Cohort studies involving atomic bomb survivors and individuals with occupational radiation exposure,even at relatively low doses,have reported a significant increase in RIHD risks.The pathological mechanisms underlying RIHD have been extensively reviewed.At present,imaging techniques and traditional cardiac biomarkers are the primary methods to diagnose RIHD,with ongoing efforts to explore additional promising markers for predicting and monitoring RIHD.Moreover,traditional and novel therapeutic strategies are being actively explored to prevent or alleviate RIHD.Insights gained from therapeutic advancements in other organ systems or heart diseases caused by different factors can provide valuable ideas for RIHD management.This review discusses the recent advancements in the diagnosis and treatment of RIHD.

Change in cholesterol absorption and synthesis markers in patients with coronary heart disease after combination therapy with simvastatin plus ezetimibe

Bad, round Statins and ezetimibe have been reported to change the balance of cholesterol metabolism, but few studies have been performed on Chinese patients. The aim of this study was to evaluate changes in cholesterol metabolism markers in patients with coronary heart disease. Methods Forty-five patients with coronary heart disease were treated with 20 mg/d of simvastatin for four weeks. Subjects were then divided into two different therapy groups according to whether they reached the target values for total cholesterol and low density lipoprotein cholesterol level. Patients who reached the target values remained on simvastatin and those who did not reach the target values took a combination of simvastatin plus 10 mg/d ezetimibe until the 12th week. The concentrations of cholesterol synthesis markers （lathosterol and desmosterol） and absorption markers （campesterol and sitosterol） were measured on the 1st, 4th, and 12th week of the study by gas chromatography. Results After treatment with simvastatin for four weeks, the levels of total cholesterol and low density lipoprotein cholesterol decreased significantly compared to levels measured during the 1st week （P 〈0.05）. On the 12th week the levels of total cholesterol and low density lipoprotein cholesterol had decreased significantly （P 〈0.001） compared to levels during the 4th week. By the 12th week the levels of campesterol and sitosterol in the combination group had decreased significantly （P〈0.05） compared with levels measured during the 4th week. Conclusions Coronary heart disease patients with high cholesterol synthesis at baseline might gain a greater benefit from simvastatin treatment. Combination therapy with simvastatin plus ezetimibe in patients with low cholesterol synthesis at baseline might increase the success rate of lipid-lowering throuah decreasing the absorption of cholesterol.

Effect of thermal therapy using hot water bottles on brain natriuretic peptide in chronic hemodialysis patients

Introduction: The use of repeated thermal therapy for improving the symptoms of chronic heart failure (CHF) has been recently demonstrated. Usually, thermal therapy requires an infrared dry sauna. However, it is difficult for small clinics to acquire such an expensive and extensive system. The author assessed the efficacy of its substitution with hot water bottles. Moreover, there are no prior studies demonstrating the efficacy of thermal therapy in hemodialysis patients with chronic heart failure. Methods: The author evaluated plasma brain natriuretic peptide (BNP) levels in 98 hemodialysis patients in a clinic. A total of nine patients whose BNP levels were more than 500 pg/mL agreed to be enrolled in this study and received thermal therapy using hot water bottles. Results: Plasma BNP levels, a potential marker for CHF, tended to decrease (891 ± 448 pg/mL to 680 ± 339 pg/mL), but the difference was not significant (P = 0.0845). The oral temperature changed from 36.44℃± 0.45℃ to 37.04℃ ± 0.48℃ (+0.597℃, P < 0.0001). No side effects were experienced during the therapy. Moreover, most patients had an improvement in their symptoms and the ability to perform activities of daily living. Conclusion: Thermal therapy using hot water bottles is very safe and tends to reduce plasma BNP levels in hemodialysis patients with CHF.