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Kunutsor SK, Isiozor NM, Kurl S, Laukkanen JA. Enhancing Cardiorespiratory Fitness Through Sauna Bathing: Insights From the Kuopio Ischemic Heart Disease Prospective Study. J Cardiopulm Rehabil Prev 2024; 44:295-300. [PMID: 38836690 DOI: 10.1097/hcr.0000000000000876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
PURPOSE The physiological adaptations stimulated by a sauna bath (SB) are similar to those produced by moderate- or high-intensity physical activity (PA), but the relationship between SB and cardiorespiratory fitness (CRF) is not clear. The objective of this study was to evaluate the cross-sectional and longitudinal associations between frequency and duration of SB with CRF. METHODS Baseline SB habits were assessed in 2012 men aged 42 -61 yr. CRF was directly measured using a respiratory gas exchange analyzer during cardiopulmonary exercise testing at baseline and 11 yr later. The associations of SB frequency and duration with baseline and 11-yr levels of CRF were examined using robust regression analyses adjusted for several confounders, including lifestyle factors such as PA. RESULTS In baseline analysis, a unit increase in sauna sessions/wk was associated with an increase in CRF 0.30 mL/kg/min (standard error [SE]: 0.14; P = .034). Alternatively, compared with a single sauna sessions/wk, 2-3 and 4-7 sauna sessions/wk was each associated with significant increases in levels of CRF: 0.84 mL/kg/min (SE: 0.32; P = .008) and 1.17 mL/kg/min (SE: 0.57; P = .041), respectively. In longitudinal analysis, frequent SB was associated with increases in 11-yr CRF levels, but this was only significant for 2-3 sauna sessions/wk compared with a single sauna sessions/wk: 1.22 mL/kg/min (SE: 0.59; P = .038). Duration of SB was not significantly associated with CRF levels in cross-sectional and longitudinal analyses. CONCLUSIONS Frequent SB may improve levels of CRF independently of PA. These results warrant replication in robust definitive randomized controlled trials.
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Affiliation(s)
- Setor K Kunutsor
- Author Affiliations: Leicester Real World Evidence Unit, Diabetes Research Centre (Dr Kunutsor), University of Leicester, Leicester General Hospital, Leicester, United Kingdom; Institute of Clinical Medicine (Drs Isiozor and Laukkanen), Institute of Public Health and Clinical Nutrition (Drs Kurl and Laukkanen), University of Eastern Finland, Kuopio, Finland; and Wellbeing Services County of Central Finland, Department of Medicine (Dr Laukkanen), Jyväskylä, Finland
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Schwartzman JD, McCall M, Ghattas Y, Pugazhendhi AS, Wei F, Ngo C, Ruiz J, Seal S, Coathup MJ. Multifunctional scaffolds for bone repair following age-related biological decline: Promising prospects for smart biomaterial-driven technologies. Biomaterials 2024; 311:122683. [PMID: 38954959 DOI: 10.1016/j.biomaterials.2024.122683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 06/09/2024] [Accepted: 06/23/2024] [Indexed: 07/04/2024]
Abstract
The repair of large bone defects due to trauma, disease, and infection can be exceptionally challenging in the elderly. Despite best clinical practice, bone regeneration within contemporary, surgically implanted synthetic scaffolds is often problematic, inconsistent, and insufficient where additional osteobiological support is required to restore bone. Emergent smart multifunctional biomaterials may drive important and dynamic cellular crosstalk that directly targets, signals, stimulates, and promotes an innate bone repair response following age-related biological decline and when in the presence of disease or infection. However, their role remains largely undetermined. By highlighting their mechanism/s and mode/s of action, this review spotlights smart technologies that favorably align in their conceivable ability to directly target and enhance bone repair and thus are highly promising for future discovery for use in the elderly. The four degrees of interactive scaffold smartness are presented, with a focus on bioactive, bioresponsive, and the yet-to-be-developed autonomous scaffold activity. Further, cell- and biomolecular-assisted approaches were excluded, allowing for contemporary examination of the capabilities, demands, vision, and future requisites of next-generation biomaterial-induced technologies only. Data strongly supports that smart scaffolds hold significant promise in the promotion of bone repair in patients with a reduced osteobiological response. Importantly, many techniques have yet to be tested in preclinical models of aging. Thus, greater clarity on their proficiency to counteract the many unresolved challenges within the scope of aging bone is highly warranted and is arguably the next frontier in the field. This review demonstrates that the use of multifunctional smart synthetic scaffolds with an engineered strategy to circumvent the biological insufficiencies associated with aging bone is a viable route for achieving next-generation therapeutic success in the elderly population.
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Affiliation(s)
| | - Max McCall
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Yasmine Ghattas
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Abinaya Sindu Pugazhendhi
- College of Medicine, University of Central Florida, Orlando, FL, USA; Biionix Cluster, University of Central Florida, Orlando, FL, USA
| | - Fei Wei
- College of Medicine, University of Central Florida, Orlando, FL, USA; Biionix Cluster, University of Central Florida, Orlando, FL, USA
| | - Christopher Ngo
- College of Medicine, University of Central Florida, Orlando, FL, USA; Biionix Cluster, University of Central Florida, Orlando, FL, USA
| | - Jonathan Ruiz
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Sudipta Seal
- College of Medicine, University of Central Florida, Orlando, FL, USA; Biionix Cluster, University of Central Florida, Orlando, FL, USA; Advanced Materials Processing and Analysis Centre, Nanoscience Technology Center (NSTC), Materials Science and Engineering, College of Medicine, University of Central Florida, USA, Orlando, FL
| | - Melanie J Coathup
- College of Medicine, University of Central Florida, Orlando, FL, USA; Biionix Cluster, University of Central Florida, Orlando, FL, USA.
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Laukkanen JA, Kunutsor SK. The multifaceted benefits of passive heat therapies for extending the healthspan: A comprehensive review with a focus on Finnish sauna. Temperature (Austin) 2024; 11:27-51. [PMID: 38577299 PMCID: PMC10989710 DOI: 10.1080/23328940.2023.2300623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/22/2023] [Indexed: 04/06/2024] Open
Abstract
Passive heat therapy is characterized by exposure to a high environmental temperature for a brief period. There are several types of passive heat therapy which include hot tubs, Waon therapy, hydrotherapy, sanarium, steam baths, infrared saunas and Finnish saunas. The most commonly used and widely studied till date are the Finnish saunas, which are characterized by high temperatures (ranging from 80-100°C) and dry air with relative humidity varying from 10-20%. The goal of this review is to provide a summary of the current evidence on the impact of passive heat therapies particularly Finnish saunas on various health outcomes, while acknowledging the potential of these therapies to contribute to the extension of healthspan, based on their demonstrated health benefits and disease prevention capabilities. The Finnish saunas have the most consistent and robust evidence regarding health benefits and they have been shown to decrease the risk of health outcomes such as hypertension, cardiovascular disease, thromboembolism, dementia, and respiratory conditions; may improve the severity of musculoskeletal disorders, COVID-19, headache and flu, while also improving mental well-being, sleep, and longevity. Finnish saunas may also augment the beneficial effects of other protective lifestyle factors such as physical activity. The beneficial effects of passive heat therapies may be linked to their anti-inflammatory, cytoprotective and anti-oxidant properties and synergistic effects on neuroendocrine, circulatory, cardiovascular and immune function. Passive heat therapies, notably Finnish saunas, are emerging as potentially powerful and holistic strategies to promoting health and extending the healthspan in all populations.
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Affiliation(s)
- Jari A. Laukkanen
- Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Wellbeing Services County of Central Finland, Jyväskylä, Finland
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van Kraaij SJW, Hamblin MR, Pickering G, Giannokopoulos B, Kechemir H, Heinz M, Igracki-Turudic I, Yavuz Y, Rissmann R, Gal P. A Phase 1 randomized, open-label clinical trial to evaluate the effect of a far-infrared emitting patch on local skin perfusion, microcirculation and oxygenation. Exp Dermatol 2024; 33:e14962. [PMID: 37950549 DOI: 10.1111/exd.14962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/06/2023] [Accepted: 10/06/2023] [Indexed: 11/12/2023]
Abstract
Far-infrared radiation (FIR) has been investigated for reduction of pain and improvement of dermal blood flow. The FIRTECH patch is a medical device designed to re-emit FIR radiated by the body. This phase 1 study was conducted to evaluate the local effects of the FIRTECH patch on local skin perfusion, microcirculation and oxygenation. This prospective, randomized, open-label, parallel designed study admitted 20 healthy participants to a medical research facility for treatment for 31 h on three anatomical locations. During treatment, imaging assessments consisting of laser speckle contrast imaging, near-infrared spectroscopy, side-stream dark-field microscopy, multispectral imaging and thermography were conducted regularly on patch-treated skin and contralateral non-treated skin. The primary endpoint was baseline perfusion increase during treatment on the upper back. Secondary endpoints included change in baseline perfusion, oxygen consumption and temperature of treated versus untreated areas. The primary endpoint was not statistically significantly different between treated and non-treated areas. The secondary endpoints baseline perfusion on the forearm (least square means [LSMs] difference 2.63 PU, 95% CI: 0.97, 4.28), oxygen consumption (LSMs difference: 0.42 arbitrary units [AUs], 95% CI: 0.04, 0.81) and skin temperature (LSMs difference 0.35°C, 95% CI: 0.16, 0.6) were statistically significantly higher in treated areas. Adverse events observed during the study were mild and transient. The vascular response to the FIRTECH patch was short-lived suggesting a non-thermal vasodilatory effect of the patch. The FIRTECH patch was well tolerated, with mild and transient adverse events observed during the study. These results support the therapeutic potential of FIR in future investigations.
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Affiliation(s)
- Sebastiaan J W van Kraaij
- Centre for Human Drug Research, Leiden, the Netherlands
- Leiden University Medical Centre, Leiden, the Netherlands
| | - Michael R Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Johannesburg, South Africa
| | - Gisele Pickering
- Clinical Investigation Center CIC Inserm 1405, University Hospital Clermont-Ferrand, Clermont-Ferrand, France
| | | | | | - Moritz Heinz
- Research & Development, Sanofi, Chilly-Mazarin, France
| | | | - Yalçin Yavuz
- Centre for Human Drug Research, Leiden, the Netherlands
| | - Robert Rissmann
- Centre for Human Drug Research, Leiden, the Netherlands
- Leiden Academic Centre for Drug Research, Leiden, the Netherlands
| | - Pim Gal
- Centre for Human Drug Research, Leiden, the Netherlands
- Leiden University Medical Centre, Leiden, the Netherlands
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Debray A, Gravel H, Garceau L, Bartlett AA, Chaseling GK, Barry H, Behzadi P, Ravanelli N, Iglesies-Grau J, Nigam A, Juneau M, Gagnon D. Finnish sauna bathing and vascular health of adults with coronary artery disease: a randomized controlled trial. J Appl Physiol (1985) 2023; 135:795-804. [PMID: 37650138 DOI: 10.1152/japplphysiol.00322.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 09/01/2023] Open
Abstract
Regular Finnish sauna use is associated with a reduced risk of cardiovascular mortality. However, physiological mechanisms underlying this association remain unknown. This study determined if an 8-wk Finnish sauna intervention improves peripheral endothelial function, microvascular function, central arterial stiffness, and blood pressure in adults with coronary artery disease (CAD). Forty-one adults (62 ± 6 yr, 33 men/8 women) with stable CAD were randomized to 8 wk of Finnish sauna use (n = 21, 4 sessions/wk, 20-30 min/session, 79°C, 13% relative humidity) or a control intervention (n = 20, lifestyle maintenance). Brachial artery flow-mediated dilation (FMD), carotid-femoral pulse wave velocity (cf-PWV), total (area under the curve) and peak postocclusion forearm reactive hyperemia, and blood pressure (automated auscultation) were measured before and after the intervention. After the sauna intervention, resting core temperature was lower (-0.27°C [-0.54, -0.01], P = 0.046) and sweat rate during sauna exposure was greater (0.3 L/h [0.1, 0.5], P = 0.003). The change in brachial artery FMD did not differ between interventions (control: 0.07% [-0.99, +1.14] vs. sauna: 0.15% [-0.89, +1.19], interaction P = 0.909). The change in total (P = 0.031) and peak (P = 0.024) reactive hyperemia differed between interventions due to a nonsignificant decrease in response to the sauna intervention and an increase in response to control. The change in cf-PWV (P = 0.816), systolic (P = 0.951), and diastolic (P = 0.292) blood pressure did not differ between interventions. These results demonstrate that four sessions of Finnish sauna bathing per week for 8 wk does not improve markers of vascular health in adults with stable CAD.NEW & NOTEWORTHY This study determined if unsupervised Finnish sauna bathing for 8 wk improves markers of vascular health in adults with coronary artery disease. Finnish sauna bathing reduced resting core temperature and improved sweating capacity, indicative of heat acclimation. Despite evidence of heat acclimation, Finnish sauna bathing did not improve markers of endothelial function, microvascular function, arterial stiffness, or blood pressure.
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Affiliation(s)
- Amélie Debray
- Montreal Heart Institute, Montreal, Quebec, Canada
- School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Hugo Gravel
- Montreal Heart Institute, Montreal, Quebec, Canada
- School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | | | - Audrey-Ann Bartlett
- Montreal Heart Institute, Montreal, Quebec, Canada
- School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Georgia K Chaseling
- Engagement and Co-design Research Hub, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | | | | | - Nicholas Ravanelli
- School of Kinesiology, Lakehead University, Thunder Bay, Ontario, Canada
| | | | - Anil Nigam
- Montreal Heart Institute, Montreal, Quebec, Canada
| | | | - Daniel Gagnon
- Montreal Heart Institute, Montreal, Quebec, Canada
- School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
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Kunutsor SK, Laukkanen JA. Does the Combination of Finnish Sauna Bathing and Other Lifestyle Factors Confer Additional Health Benefits? A Review of the Evidence. Mayo Clin Proc 2023; 98:915-926. [PMID: 37270272 DOI: 10.1016/j.mayocp.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 06/05/2023]
Abstract
Sauna bathing, a tradition deeply rooted in the Finnish culture, has been used for thousands of years for leisure, relaxation, and wellness. Sauna bathing is linked with substantial health benefits beyond its use for leisure and relaxation. Several observational and interventional studies suggest that regular or frequent sauna bathing reduces the incidence of vascular and nonvascular diseases, such as hypertension, cardiovascular disease, dementia, and respiratory conditions; may improve the severity of conditions such as musculoskeletal disorders, COVID-19, headache, and influenza; and increases the life span. The beneficial effects of sauna bathing on adverse outcomes have been linked to its blood pressure-reducing, anti-inflammatory, antioxidant, cytoprotective, and stress-reducing properties and its synergistic effect on neuroendocrine, circulatory, cardiovascular, and immune function. Evidence suggests that frequent sauna bathing is an emerging protective risk factor that may augment the beneficial effects of other protective risk or lifestyle factors, such as physical activity and cardiorespiratory fitness, or attenuate or offset the adverse effects of other risk factors, such as high blood pressure, systemic inflammation, and low socioeconomic status. This review summarizes the available epidemiologic and interventional evidence linking the combined effects of Finnish sauna bathing and other risk factors on vascular outcomes including cardiovascular disease and intermediate cardiovascular phenotypes, nonvascular outcomes, and mortality. We also discuss the mechanistic pathways underlying the joint contributions of Finnish sauna bathing and other risk factors on health outcomes, the public health and clinical implications of the findings, gaps in the existing evidence base, and future directions.
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Affiliation(s)
- Setor K Kunutsor
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, United Kingdom.
| | - Jari A Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland; Central Finland Health Care District, Department of Medicine, Jyväskylä, Finland District, Jyväskylä, Finland
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Li Z, Li X, Yan F, Liu L, Bai T, Jiang W, Dong R. Remodeling of the cardiovascular hemodynamic environment by lower limb heat exposure: A computational fluid dynamic study. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 238:107626. [PMID: 37263116 DOI: 10.1016/j.cmpb.2023.107626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/15/2023] [Accepted: 05/27/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Lower limb heat exposure (LLHE) is a promising strategy for the daily management of cardiovascular health because of its non-pharmaceutical advantages. To support the application of this strategy in cardiovascular protection, we examined its impact on the global hemodynamic environment. METHODS Skin blood flow (SBF) of eight locations on the lower limbs was measured before and after LLHE (40 °C and 44 °C) in ten healthy subjects by using a laser Doppler flowmeter. A closed-loop model of circulation uses changes in SBF to quantify the influence of LLHE on the blood flow of the arterial trunk (from ascending aorta to the femoral artery) and visceral branches (coronary, celiac, renal, and mesenteric arteries). RESULTS The SBF in all locations tested on the lower limbs increased significantly (p<0.001) with LLHE and a 3.39-fold and 7.40-fold increase in mean SBF were observed under 40 °C and 44 °C conditions, respectively. In the model, the peak (3.9-25.1%), end-diastolic (13.7-107.3%), and mean blood flow (8.5-86.5%) in the arterial trunk increased with the increase in temperature, but the retrograde flow in the thoracic aorta and abdominal aorta Ⅰ increased at least twice in the diastolic period. Furthermore, LLHE also increased the blood flow of the visceral branches (2.5-20.7%). CONCLUSION These findings suggest that LLHE is expected to be a daily strategy for enhancing the functions of both the arterial trunk and visceral arteries, but the increased blood flow reversal in the thoracic and abdominal aortas warrants further investigation.
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Affiliation(s)
- Zhongyou Li
- Sichuan Province Biomechanical Engineering Laboratory, Chengdu, China; Department of Mechanical Science and Engineering, Sichuan University, Chengdu, China
| | - Xiao Li
- Sichuan Province Biomechanical Engineering Laboratory, Chengdu, China; Department of Mechanical Science and Engineering, Sichuan University, Chengdu, China
| | - Fei Yan
- Chongqing University Three Gorges Hospital, Chongqing University, Chongqing, China
| | - Lingjun Liu
- Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Taoping Bai
- Sichuan Province Biomechanical Engineering Laboratory, Chengdu, China; Department of Mechanical Science and Engineering, Sichuan University, Chengdu, China
| | - Wentao Jiang
- Sichuan Province Biomechanical Engineering Laboratory, Chengdu, China; Department of Mechanical Science and Engineering, Sichuan University, Chengdu, China.
| | - Ruiqi Dong
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China
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Siquier-Coll J, Bartolomé I, Pérez-Quintero M, Toro-Román V, Grijota FJ, Maynar-Mariño M. Heart Rate and Body Temperature Evolution in an Interval Program of Passive Heat Acclimation at High Temperatures (100 ± 2 °C) in a Sauna. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2082. [PMID: 36767447 PMCID: PMC9916041 DOI: 10.3390/ijerph20032082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
Heat exposure provokes stress on the human body. If it remains constant, it leads to adaptations such as heat acclimation. This study aims to observe the evolution of heart rate (HR), core temperature (Tcore), and skin temperature (Tskin) in an intervallic program of exposure to extreme heat. Twenty-nine healthy male volunteers were divided into a control group (CG; n = 14) and an experimental group (EG; n = 15). EG experienced nine sessions (S) of intervallic exposure to high temperatures (100 ± 2 °C), whereas CG was exposed to ambient temperatures (22 ± 2 °C). HR, Tskin, and Tcore were monitored in S1, 4, 5, 8, and 9. An important increase in HR occurred in the S4 compared to the rest (p < 0.05) in EG. A lower HR was discovered in S8 and S9 compared to S4 and in S9 in relation to S1 (p < 0.05) in EG. EG experiences a gradual decrease in Tcore and Tskin, which was detected throughout the assessments, although it was only significant in the S8 and S9 (p < 0.05). Interval exposure to heat at 100 ± 2 °C elicits stress on the human organism, fundamentally increasing Tcore, Tskin, and FC. This recurring stress in the full program caused a drop in the thermoregulatory response as an adaptation or acclimation to heat.
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Affiliation(s)
- Jesús Siquier-Coll
- SER Research Group, Center of Higher Education Alberta Giménez, Comillas Pontifical University, Costa de Saragossa 16, 07013 Palma Mallorca, Spain
| | - Ignacio Bartolomé
- Department of Sport Science, Faculty of Education, Pontifical University of Salamanca, C/Henry Collet, 52-70, 37007 Salamanca, Spain
| | - Mario Pérez-Quintero
- Faculty of Sport Sciences, University of Extremadura, Avenida de la Universidad s/n, 10003 Caceres, Spain
| | - Víctor Toro-Román
- Faculty of Sport Sciences, University of Extremadura, Avenida de la Universidad s/n, 10003 Caceres, Spain
| | - Francisco J. Grijota
- Faculty of Sport Sciences, University of Extremadura, Avenida de la Universidad s/n, 10003 Caceres, Spain
| | - Marcos Maynar-Mariño
- Faculty of Sport Sciences, University of Extremadura, Avenida de la Universidad s/n, 10003 Caceres, Spain
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Kjertakov M, Petersen A. Hot water immersion could be an effective alternative to physical exercise in improving cardiovascular fitness during the COVID-19 pandemic. Front Physiol 2022; 13:1035183. [PMID: 36505081 PMCID: PMC9732457 DOI: 10.3389/fphys.2022.1035183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/31/2022] [Indexed: 11/26/2022] Open
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Monroe JC, Pae BJ, Kargl C, Gavin TP, Parker J, Perkins SM, Han Y, Klein J, Motaganahalli RL, Roseguini BT. Effects of home-based leg heat therapy on walking performance in patients with symptomatic peripheral artery disease: a pilot randomized trial. J Appl Physiol (1985) 2022; 133:546-560. [PMID: 35771219 PMCID: PMC9448284 DOI: 10.1152/japplphysiol.00143.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/15/2022] [Accepted: 06/21/2022] [Indexed: 11/22/2022] Open
Abstract
Few noninvasive therapies currently exist to improve functional capacity in people with lower extremity peripheral artery disease (PAD). The goal of the present study was to test the hypothesis that unsupervised, home-based leg heat therapy (HT) using water-circulating trousers perfused with warm water would improve walking performance in patients with PAD. Patients with symptomatic PAD were randomized into either leg HT (n = 18) or a sham treatment (n = 16). Patients were provided with water-circulating trousers and a portable pump and were asked to apply the therapy daily (7 days/wk, 90 min/session) for 8 wk. The primary study outcome was the change from baseline in 6-min walk distance at 8-wk follow-up. Secondary outcomes included the claudication onset-time, peak walking time, peak pulmonary oxygen consumption and peak blood pressure during a graded treadmill test, resting blood pressure, the ankle-brachial index, postocclusive reactive hyperemia in the calf, cutaneous microvascular reactivity, and perceived quality of life. Of the 34 participants randomized, 29 completed the 8-wk follow-up. The change in 6-min walk distance at the 8-wk follow-up was significantly higher (P = 0.029) in the group exposed to HT than in the sham-treated group (Sham: median: -0.9; 25%, 75% percentiles: -5.8, 14.3; HT: median: 21.3; 25%, 75% percentiles: 10.1, 42.4, P = 0.029). There were no significant differences in secondary outcomes between the HT and sham group at 8-wk follow-up. The results of this pilot study indicate that unsupervised, home-based leg HT is safe, well-tolerated, and elicits a clinically meaningful improvement in walking tolerance in patients with symptomatic PAD.NEW & NOTEWORTHY This is the first sham-controlled trial to examine the effects of home-based leg heat therapy (HT) on walking performance in patients with peripheral artery disease (PAD). We demonstrate that unsupervised HT using water-circulating trousers is safe, well-tolerated, and elicits meaningful changes in walking ability in patients with symptomatic PAD. This home-based treatment option is practical, painless, and may be a feasible adjunctive therapy to counteract the decline in lower extremity physical function in patients with PAD.
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Affiliation(s)
- Jacob C Monroe
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Byung Joon Pae
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Christopher Kargl
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Timothy P Gavin
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Jason Parker
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana
| | - Susan M Perkins
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana
| | - Yan Han
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana
| | - Janet Klein
- Division of Vascular Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Raghu L Motaganahalli
- Division of Vascular Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Bruno T Roseguini
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
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Lee E, Kolunsarka IA, Kostensalo J, Ahtiainen JP, Haapala EA, Willeit P, Kunutsor SK, Laukkanen JA. The effects of regular sauna bathing in conjunction with exercise on cardiovascular function: A multi-arm randomized controlled trial. Am J Physiol Regul Integr Comp Physiol 2022; 323:R289-R299. [PMID: 35785965 PMCID: PMC9394774 DOI: 10.1152/ajpregu.00076.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Regular exercise and sauna bathing have each been shown to improve cardiovascular function in clinical populations. However, experimental data on the cardiovascular adaptations to regular exercise in conjunction with sauna bathing in the general population is lacking. Therefore, we compared the effects of exercise and sauna bathing, to regular exercise using a multi-arm randomized controlled trial. Participants (n = 47) aged 49 ± 9 years with low physical activity levels, and at least one traditional CVD risk factor were randomly assigned (1:1:1) to guideline-based regular exercise and 15-minute post-exercise sauna (EXS), guideline-based regular exercise (EXE), or control (CON), for eight weeks. The primary outcomes were blood pressure (BP) and cardiorespiratory fitness (CRF). Secondary outcomes included fat mass, total cholesterol levels, and arterial stiffness. EXE had a greater change in CRF (+6.2 ml/kg/min; 95% CI, +4.2. to +8.3 ml/kg/min) and fat mass, but no differences in BP when compared to CON. EXS displayed greater change in CRF (+2.7 ml/kg/min; 95% CI, +0.2. to +5.3 ml/kg/min), lower systolic BP (-8.0 mmHg; 95% CI, -14.6 to -1.4 mmHg) and lower total cholesterol levels compared to EXE. Regular exercise improved CRF and body composition in sedentary adults with CVD risk factors. However, when combined with exercise, sauna bathing demonstrated a substantially supplementary effect on CRF, systolic BP, and total cholesterol levels. Sauna bathing is a valuable lifestyle tool that complements exercise for improving CRF, and decreasing systolic BP. Future research should focus on the duration, and frequency of exposure to ascertain the dose-response relationship.
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Affiliation(s)
- Earric Lee
- Faculty of Sports and Health Sciences, grid.9681.6University of Jyväskylä, Jyväskylä, Finland
| | - Iiris A Kolunsarka
- Faculty of Sports and Health Sciences, grid.9681.6University of Jyväskylä, Jyväskylä, Finland
| | - Joel Kostensalo
- grid.22642.30Natural Resources Institute Finland, Joensuu, Finland
| | - Juha P Ahtiainen
- Department of Biology of Physical Activity, grid.9681.6University of Jyväskylä, Jyväskylä, Finland
| | - Eero A Haapala
- Faculty of Sport and Health Sciences, grid.9681.6University of Jyväskylä, Jyväskylä, Finland
| | - Peter Willeit
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Setor K Kunutsor
- Translational Health Sciences, grid.5337.2University of Bristol, Bristol, United Kingdom
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Far-Infrared Therapy Decreases Orthotopic Allograft Transplantation Vasculopathy. Biomedicines 2022; 10:biomedicines10051089. [PMID: 35625826 PMCID: PMC9139124 DOI: 10.3390/biomedicines10051089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/30/2022] [Accepted: 05/04/2022] [Indexed: 01/27/2023] Open
Abstract
Orthotopic allograft transplantation (OAT) is a major strategy for solid heart and kidney failure. However, the recipient’s immunity-induced chronic rejection induces OAT vasculopathy that results in donor organ failure. With the exception of immunosuppressive agents, there are currently no specific means to inhibit the occurrence of OAT vasculopathy. On the other hand, far-infrared (FIR) therapy uses low-power electromagnetic waves given by FIR, with a wavelength of 3–25 μm, to improve human physiological functions. Previous studies have shown that FIR therapy can effectively inhibit inflammation. It has also been widely used in adjuvant therapy for various clinical diseases, especially cardiovascular diseases, in recent years. Thus, we used this study to explore the feasibility of FIR in preventing OAT vasculopathy. In this study, the model of transplantation of an aorta graft from PVG/Seac rat to ACI/NKyo rat, and in vitro model of human endothelial progenitor cells (EPCs) was used. In this report, we presented that FIR therapy decreased the serious of vasculopathy in OAT-recipient ACI/NKyo rats via inhibiting proliferation of smooth muscle cells, accumulation of collagen, and infiltration of fibroblast in the vessel wall; humoral and cell-mediated immune responses were decreased in the spleen. The production of inflammatory proteins/cytokines also decreased in the plasma. Additionally, FIR therapy presented higher mobilization and circulating EPC levels associated with vessel repair in OAT-recipient ACI/NKyo rats. In vitro studies demonstrated that the underlying mechanisms of FIR therapy inhibiting OAT vasculopathy may be associated with the inhibition of the Smad2-Slug axis endothelial mesenchymal transition (EndoMT). Thus, FIR therapy may be the strategy to prevent chronic rejection-induced vasculopathy.
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13
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Pettit-Mee RJ, Power G, Cabral-Amador FJ, Ramirez-Perez FI, Nogueira Soares R, Sharma N, Liu Y, Christou DD, Kanaley JA, Martinez-Lemus LA, Manrique-Acevedo CM, Padilla J. Endothelial HSP72 is not reduced in type 2 diabetes nor is it a key determinant of endothelial insulin sensitivity. Am J Physiol Regul Integr Comp Physiol 2022; 323:R43-R58. [PMID: 35470695 DOI: 10.1152/ajpregu.00006.2022] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Impaired endothelial insulin signaling and consequent blunting of insulin-induced vasodilation is a feature of type 2 diabetes (T2D) that contributes to vascular disease and glycemic dysregulation. However, the molecular mechanisms underlying endothelial insulin resistance remain poorly known. Herein, we tested the hypothesis that endothelial insulin resistance in T2D is attributed to reduced expression of heat shock protein 72(HSP72). HSP72 is a cytoprotective chaperone protein that can be upregulated with heating and is reported to promote insulin sensitivity in metabolically active tissues, in part via inhibition of JNK activity. Accordingly, we further hypothesized that, in T2D individuals, seven days of passive heat treatment via hot water immersion to waist-level would improve leg blood flow responses to an oral glucose load (i.e., endogenous insulin stimulation) via induction of endothelial HSP72. In contrast, we found that: 1) endothelial insulin resistance in T2D mice and humans was not associated with reduced HSP72 in aortas and venous endothelial cells, respectively; 2) after passive heat treatment, improved leg blood flow responses to an oral glucose load did not parallel with increased endothelial HSP72; 3) downregulation of HSP72 (via small-interfering RNA) or upregulation of HSP72 (via heating) in cultured endothelial cells did not impair or enhance insulin signaling, respectively, nor was JNK activity altered. Collectively, these findings do not support the hypothesis that reduced HSP72 is a key driver of endothelial insulin resistance in T2D but provide novel evidence that lower-body heating may be an effective strategy for improving leg blood flow responses to glucose ingestion-induced hyperinsulinemia.
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Affiliation(s)
- Ryan J Pettit-Mee
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | - Gavin Power
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | | | | | | | - Neekun Sharma
- Department of Medicine, University of Missouri, Columbia, MO, United States
| | - Ying Liu
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | - Demetra D Christou
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Jill A Kanaley
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States
| | - Luis A Martinez-Lemus
- Department of Medicine, University of Missouri, Columbia, MO, United States.,Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO, United States.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, United States
| | - Camila M Manrique-Acevedo
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, United States.,Division of Endocrinology, Diabetes and Metabolism, Department of Medicine University of Missouri, Columbia, MO, United States.,Research Services, Harry S. Truman Memorial Veterans Hospital, Columbia, MO, United States
| | - Jaume Padilla
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, United States.,Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, United States
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Behzadi P, Ravanelli N, Gravel H, Barry H, Debray A, Chaseling GK, Jacquemet V, Neagoe PE, Nigam A, Carpentier AC, Sirois MG, Gagnon D. Acute effect of passive heat exposure on markers of cardiometabolic function in adults with type 2 diabetes mellitus. J Appl Physiol (1985) 2022; 132:1154-1166. [PMID: 35323077 DOI: 10.1152/japplphysiol.00800.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
AIM Heat therapy is a promising strategy to improve cardiometabolic health. This study evaluated the acute physiological responses to hot water immersion in adults with type 2 diabetes mellitus (T2DM). METHODS On separate days in randomized order, 13 adults with T2DM (8 males/5 females, 62 ± 12 yrs, BMI: 30.1 ± 4.6 kg/m2) were immersed in thermoneutral (34°C, 90 minutes) or hot (41°C, core temperature ≥38.5°C for 60 minutes) water. Insulin sensitivity was quantified via the minimal oral model during an oral glucose tolerance test (OGTT) performed 60 minutes after immersion. Brachial artery flow-mediated dilation (FMD) and reactive hyperemia were evaluated before and 40 minutes after immersion. Blood samples were drawn to quantify protein concentrations and mRNA levels of HSP70 and 90, and circulating concentrations of cytokines. RESULTS Relative to thermoneutral water immersion, hot water immersion increased core temperature (+1.66°C [+1.47, +1.87], P<0.01), heart rate (+34 bpm [+24, +44], P<0.01), antegrade shear rate (+96 s-1 [+57, +134], P<0.01), and IL-6 (+1.38 pg/mL [+0.31, +2.45], P=0.01). Hot water immersion did not exert an acute change in insulin sensitivity (-0.3 dl/kg/min/μU/ml [-0.9, +0.2], P=0.18), FMD (-1.0% [-3.6, +1.6], P=0.56), peak (+0.36 mL/min/mmHg [-0.71, +1.43], P=0.64) and total (+0.11 mL/min/mmHg x min [-0.46, +0.68], P=0.87) reactive hyperemia. There was also no change in eHSP70 (P=0.64), iHSP70 (P=0.06), eHSP90 (P=0.80), iHSP90 (P=0.51), IL1-RA (P=0.11), GLP-1 (P=0.59) and NFkB (P=0.56) after hot water immersion. CONCLUSION The physiological responses elicited by hot water immersion do not acutely improve markers of cardiometabolic function in adults with T2DM.
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Affiliation(s)
- Parya Behzadi
- Montreal Heart Institute, Montreal, Canada.,Department of pharmacology and physiology, Université de Montréal, Montréal, Canada
| | | | - Hugo Gravel
- Montreal Heart Institute, Montreal, Canada.,School of Kinesiology and Exercise Science, Université de Montréal, Montréal, Canada
| | - Hadiatou Barry
- Montreal Heart Institute, Montreal, Canada.,Department of pharmacology and physiology, Université de Montréal, Montréal, Canada
| | - Amelie Debray
- Montreal Heart Institute, Montreal, Canada.,Department of Medicine, Université de Montréal, Montréal, Canada
| | - Georgia K Chaseling
- Montreal Heart Institute, Montreal, Canada.,Department of pharmacology and physiology, Université de Montréal, Montréal, Canada
| | - Vincent Jacquemet
- Department of pharmacology and physiology, Université de Montréal, Montréal, Canada
| | | | - Anil Nigam
- Montreal Heart Institute, Montreal, Canada.,Department of Medicine, Université de Montréal, Montréal, Canada
| | - André C Carpentier
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Canada
| | - Martin G Sirois
- Montreal Heart Institute, Montreal, Canada.,Department of pharmacology and physiology, Université de Montréal, Montréal, Canada
| | - Daniel Gagnon
- Montreal Heart Institute, Montreal, Canada.,Department of pharmacology and physiology, Université de Montréal, Montréal, Canada.,School of Kinesiology and Exercise Science, Université de Montréal, Montréal, Canada
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15
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The acute effects of passive heating on endothelial function, muscle microvascular oxygen delivery, and expression of serum HSP90α. Microvasc Res 2022; 142:104356. [PMID: 35276210 DOI: 10.1016/j.mvr.2022.104356] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 03/01/2022] [Accepted: 03/04/2022] [Indexed: 11/22/2022]
Abstract
Passive heating has been a therapeutic tool used to elevate core temperature and induce increases in cardiac output, blood flow, and shear stress. We aimed to determine the effects of a single bout of passive heating on endothelial function and serum heat shock protein 90α (HSP90α) levels in young, healthy subjects. 8 healthy subjects were recruited to participate in one bout of whole-body passive heating via immersion in a 40 °C hot tub to maintain a 1 °C increase in rectal temperature for 60 min. Twenty-four hours after heating, shear-rate corrected endothelium-dependent dilation increased (pre: 0.004 ± 0.002%SRAUC; post: 0.006 ± 0.003%SRAUC; p = 0.034) but serum [HSP90α] was not changed (pre: 36.7 ± 10.3 ng/mL; post: 40.6 ± 15.9 ng/mL; p = 0.39). Neither resting muscle O2 utilization (pre: 0.17 ± 0.11 ml O2 min-1 (100 g)-1; post: 0.14 ± 0.09 ml O2 min-1 (100 g)-1); p = 0.28) nor mean arterial pressure (pre: 74 ± 11 mmHg; post: 73 ± 11 mmHg; p = 0.79) were influenced by the heating intervention. Finally, time to peak after cuff release was significantly delayed for % O2 sat (TTPpre = 39 ± 8.9 s and TTPpost = 43.5 ± 8.2 s; p = 0.007) and deoxy-[heme] (TTPpre = 41.3 ± 18.1 s and TTPpost = 51.4 ± 16.3 s; p = 0.018), with no effect on oxy-[heme] (p = 0.19) and total-[heme] (p = 0.41). One bout of passive heating improved endothelium-dependent dilation 24 h later in young, healthy subjects. This data suggests that passive heat treatments may provide a simple intervention for improving vascular health.
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16
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Kunutsor SK, Jae SY, Kurl S, Kauhanen J, Laukkanen JA. Inflammation, sauna bathing, and all-cause mortality in middle-aged and older Finnish men: a cohort study. Eur J Epidemiol 2022; 37:1225-1231. [PMID: 36255556 PMCID: PMC9792415 DOI: 10.1007/s10654-022-00926-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 09/26/2022] [Indexed: 12/30/2022]
Abstract
Inflammation and sauna bathing are each related to the risk of all-cause mortality. The interplay between inflammation, sauna bathing and all-cause mortality is not well understood. We aimed to evaluate the separate and joint associations of inflammation (high sensitivity C-reactive protein, hsCRP) and frequency of sauna bathing (FSB) with all-cause mortality in a cohort of Caucasian men. We used the Kuopio Ischaemic Heart Disease Study cohort comprising 2575 men aged 42-61 years at baseline. Serum hsCRP was measured using an immunometric assay and sauna bathing habits were assessed by a self-administered questionnaire. High sensitivity CRP was categorized as normal and high (≤ 3 and > 3 mg/L, respectively) and FSB as low and high (defined as ≤ 2 and 3-7 sessions/week respectively). A total of 1618 deaths occurred during a median follow-up of 27.8 years. Comparing high vs normal hsCRP levels, the multivariable-adjusted HR (95% CI) for all-cause mortality was 1.27 (1.13-1.44). Comparing high vs low FSB, the multivariable-adjusted HR (95% CI) for all-cause mortality was 0.86 (0.76-0.97). Compared with normal hsCRP-low FSB, high hsCRP-low FSB was associated with an increased risk of all-cause mortality 1.28 (1.12-1.47), with no evidence of an association for high hsCRP-high FSB and all-cause mortality risk 1.06 (0.81-1.40). Positive additive and multiplicative interactions were found between hsCRP and FSB in relation to mortality. In a general Finnish male population, both hsCRP and FSB are each independently associated with all-cause mortality. However, frequent sauna baths appear to offset the increased all-cause mortality risk related to high hsCRP levels.
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Affiliation(s)
- Setor K. Kunutsor
- grid.410421.20000 0004 0380 7336National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK ,grid.5337.20000 0004 1936 7603Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, BS10 5NB UK ,grid.9918.90000 0004 1936 8411Diabetes Research Centre, Leicester General Hospital, University of Leicester, Gwendolen Road, Leicester, LE5 4WP UK
| | - Sae Young Jae
- grid.267134.50000 0000 8597 6969Graduate School of Urban Public Health, University of Seoul, Seoul, Republic of Korea ,grid.267134.50000 0000 8597 6969Department of Sport Science, University of Seoul, Seoul, South Korea ,grid.267134.50000 0000 8597 6969Department of Urban Big Data Convergence, University of Seoul, Seoul, Republic of Korea
| | - Sudhir Kurl
- grid.9668.10000 0001 0726 2490Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jussi Kauhanen
- grid.9668.10000 0001 0726 2490Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jari A. Laukkanen
- grid.9668.10000 0001 0726 2490Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland ,grid.9668.10000 0001 0726 2490Department of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland ,grid.460356.20000 0004 0449 0385Department of Medicine, Central Finland Health Care District, Hospital District, Jyvaskyla, Finland
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17
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Infrared sauna as exercise-mimetic? Physiological responses to infrared sauna vs exercise in healthy women: A randomized controlled crossover trial. Complement Ther Med 2021; 64:102798. [PMID: 34954348 DOI: 10.1016/j.ctim.2021.102798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/29/2021] [Accepted: 12/22/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Passive heat therapies have been reported to have similar effects on the cardiovascular system as exercise. Studies supporting these findings in healthy populations have predominantly been done with men using warm water immersions or traditional saunas, rather than newer infrared-based saunas. OBJECTIVE To explore short-term thermal and cardiovascular responses in women using an infrared sauna as compared to moderate-intensity exercise. STUDY DESIGN Randomized controlled crossover trial with balanced allocations. SETTING Brisbane, Australia (August 2019 - March 2020) PARTICIPANTS: Ten healthy women (36 ± 9 years) INTERVENTIONS: 45 min of resting, infrared sauna or indoor bicycling PRIMARY OUTCOME MEASURES: tympanic/skin temperatures; respiratory rate; blood pressure; arterial stiffness; heart rate variability RESULTS: Tympanic temperatures were elevated during infrared sauna as compared to both control (mean diff = +1.05 oC ± SEM 0.12 oC, 95% C.I.: 0.73 - 1.36, p < 0.0005) and exercise (mean diff = +0.79 oC ± SEM 0.12 oC, 95% C.I.: 0.49 - 1.08, p < 0.0005). Respiratory rates were higher during exercise as compared to both control (mean diff = +7.66 ± SEM 1.37, 95% C.I.: 4.09 - 11.23, p < 0.0005) and infrared sauna (mean diff = +6.66 ± SEM 1.33, 95% C.I.: 3.20 - 10.11, p < 0.0005). No significant differences in non-invasive measures of blood pressure, arterial stiffness or heart rate variability were detected between any of the interventions. CONCLUSIONS These findings suggest the physiological effects of infrared sauna bathing are underpinned by thermoregulatory-induced responses, more so than exercise-mimetic cardiorespiratory or cardiovascular activations.
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18
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Lee E, Kostensalo J, Willeit P, Kunutsor SK, Laukkanen T, Zaccardi F, Khan H, Laukkanen JA. Standalone sauna vs exercise followed by sauna on cardiovascular function in non-naïve sauna users: A comparison of acute effects. Health Sci Rep 2021; 4:e393. [PMID: 34622026 PMCID: PMC8485612 DOI: 10.1002/hsr2.393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/03/2021] [Accepted: 09/06/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND AND AIMS Sauna bathing and aerobic exercise have each been shown to affect cardiovascular function. However, direct comparisons between standalone sauna bathing and a combination of exercise and sauna on vascular indices remain limited. Therefore, we conducted a cross-over study using matched durations to explore the hemodynamic changes of sauna exposure when compared to a combination of aerobic exercise and sauna exposure. METHODS Participants (N = 72) with at least one cardiovascular risk factor underwent, on two separate occasions: (a) a 30-minute sauna at 75°C (SAUNA) and (b) the combination of a 15-minute cycling exercise at 75% maximum heart rate followed by 15-minute sauna exposure (EX+SAUNA). Relative changes to arterial stiffness (PWV), augmentation index (Alx), brachial systolic and diastolic blood pressure (SBP and DBP), central SBP (cSBP), mean arterial pressure (MAP), and heart rate (HR) were compared PRE-POST and pre- to 30-minutes post-intervention (PRE-POST30). RESULTS Baseline SBP and DBP were 143 (SD 18) mmHg and 86 (SD 10) mmHg, respectively. From PRE-POST, SAUNA had lower DBP (mean difference [95% CI] 2.5 [1.0, 4.1], P = .002) and MAP (2.5 [0.6, 4.3], P = .01). However, EX+SAUNA had lower SBP (-2.7 [-4.8, -0.5], P = .02), DBP (-1.8 [-3.3, -0.4], P = .01), and MAP (-2.0 [-3.5, -0.5], P = .009) PRE-POST30. There were no statistically significant differences between SAUNA and EX+SAUNA for other measured parameters. CONCLUSION This study demonstrated that when matched for duration, EX+SAUNA and SAUNA elicit comparable acute hemodynamic alterations in middle-aged participants with cardiovascular risk factors. The sauna is a suitable option for acute blood pressure reductions in those who are unable to perform aerobic exercise, and may be a viable lifestyle treatment option to improve blood pressure control.
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Affiliation(s)
- Earric Lee
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
| | - Joel Kostensalo
- Faculty of Mathematics and Science University of Jyväskylä Jyväskylä Finland
| | - Peter Willeit
- Department of Neurology Medical University of Innsbruck Innsbruck Austria
- Department of Public Health and Primary Care University of Cambridge Cambridge UK
| | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol Bristol UK
- Translational Health Sciences, Bristol Medical School University of Bristol, Learning & Research Building (Level 1), Southmead Hospital Bristol UK
| | - Tanjaniina Laukkanen
- Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | | | - Hassan Khan
- Division of Cardiology, Department of Medicine Emory University Atlanta Georgia USA
| | - Jari A Laukkanen
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
- Department of Internal Medicine Central Finland Health Care District Jyväskylä Finland
- Institute of Clinical Medicine University of Eastern Finland Kuopio Finland
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19
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Xie J, Li L. Letter regarding 'Acute and short-term efficacy of sauna treatment on cardiovascular function: a meta-analysis'. Eur J Cardiovasc Nurs 2021; 20:728-729. [PMID: 34329398 DOI: 10.1093/eurjcn/zvab049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jian Xie
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Guangxi Cardiovascular Institute, Shuangyong Street No.6, Nanning, Guangxi 53000, China
| | - Lang Li
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Guangxi Cardiovascular Institute, Shuangyong Street No.6, Nanning, Guangxi 53000, China
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20
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Yamane H, Araki R, Doi A, Sato F, Tanaka K, Miyazaki N, Goda T, Yamada T. Successful wound healing of refractory digital ulcer in patient with systemic sclerosis by Waon therapy. J Cardiol Cases 2021; 24:190-192. [DOI: 10.1016/j.jccase.2021.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/30/2021] [Accepted: 04/06/2021] [Indexed: 10/21/2022] Open
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21
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Mahlouji M, Alizadeh Vaghasloo M, Dadmehr M, Rezaeizadeh H, Nazem E, Tajadini H. Sweating as a Preventive Care and Treatment Strategy in Traditional Persian Medicine. Galen Med J 2021; 9:e2003. [PMID: 34466623 PMCID: PMC8343902 DOI: 10.31661/gmj.v9i0.2003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/12/2020] [Accepted: 10/01/2020] [Indexed: 11/16/2022] Open
Abstract
Proper and regular sweating plays a significant thermoregulatory role. It is a common perception that, sweating has other important homeostatic functions such as clearance of excessive micronutrients, waste products of metabolic processes, and toxins from the body, which helps to maintain human good health. In addition, sweating, thermotherapy, and sauna are commonly used to treat various diseases such as cardiovascular, respiratory and joint diseases. In traditional Persian medicine (PM) textbooks, sweating is considered a preventive care and treatment strategy as well. In this study, we aim to explain the beneficial effects of sweating in human health and its role in the management of various diseases, as well as introducing the therapeutic applications of some diaphoretic plants from the viewpoint of PM. We reviewed the most famous PM textbooks such as Kamil al-Sinaa al-Tibbiya, Al-Qānūn fī al-Tibb, Zakhireye Kharazmshahi, Kholasat al-Hikmat, Exir-e-Azam, and Hifzos-sihhat-e Naseri. Also, current evidence was searched in PubMed, Web of Science, Scopus, and other relevant databases related to the topic. The results of this study revealed that PM scientists believed proper sweating removes waste products and maintains the body’s health, thus, any disturbances in the excretion of these waste products can cause diseases. They recommended the induction of sweating through hot and dry baths, sun bath, sand bath and also the use of diaphoretic herbs for the management of various diseases. Therefore, further researches are recommended to evaluate the effectiveness of these diaphoretic plants.
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Affiliation(s)
- Mahboubeh Mahlouji
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
- Department of Traditional Medicine, School of Persian Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Majid Dadmehr
- School of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Rezaeizadeh
- School of Persian Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Esmaeil Nazem
- School of Persian Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Haleh Tajadini
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
- Department of Traditional Medicine, School of Persian Medicine, Kerman University of Medical Sciences, Kerman, Iran
- Correspondence to: Haleh Tajadini, MD-PhD, Assistant Professor of Persian Medicine, Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran Telephone Number: +989131972312 Email Address:
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Patrick RP, Johnson TL. Sauna use as a lifestyle practice to extend healthspan. Exp Gerontol 2021; 154:111509. [PMID: 34363927 DOI: 10.1016/j.exger.2021.111509] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/16/2021] [Accepted: 08/02/2021] [Indexed: 12/11/2022]
Abstract
Sauna use, sometimes referred to as "sauna bathing," is characterized by short-term passive exposure to high temperatures, typically ranging from 45 °C to 100 °C (113 °F to 212 °F), depending on modality. This exposure elicits mild hyperthermia, inducing a thermoregulatory response involving neuroendocrine, cardiovascular, and cytoprotective mechanisms that work in a synergistic fashion in an attempt to maintain homeostasis. Repeated sauna use acclimates the body to heat and optimizes the body's response to future exposures, likely due to the biological phenomenon known as hormesis. In recent decades, sauna bathing has emerged as a probable means to extend healthspan, based on compelling data from observational, interventional, and mechanistic studies. Of particular interest are the findings from large, prospective, population-based cohort studies of health outcomes among sauna users that identified strong dose-dependent links between sauna use and reduced morbidity and mortality. This review presents an overview of sauna practices; elucidates the body's physiological response to heat stress and the molecular mechanisms that drive the response; enumerates the myriad health benefits associated with sauna use; and describes sauna use concerns.
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Affiliation(s)
| | - Teresa L Johnson
- TLJ Communications, LLC, 36 Creek Harbour Blvd., Freeport, FL 32439, USA.
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Koch Esteves N, Gibson OR, Khir AW, González‐Alonso J. Regional thermal hyperemia in the human leg: Evidence of the importance of thermosensitive mechanisms in the control of the peripheral circulation. Physiol Rep 2021; 9:e14953. [PMID: 34350727 PMCID: PMC8339537 DOI: 10.14814/phy2.14953] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/13/2021] [Accepted: 06/15/2021] [Indexed: 02/04/2023] Open
Abstract
Hyperthermia is thought to increase limb blood flow through the activation of thermosensitive mechanisms within the limb vasculature, but the precise vascular locus in which hyperthermia modulates perfusion remains elusive. We tested the hypothesis that local temperature-sensitive mechanisms alter limb hemodynamics by regulating microvascular blood flow. Temperature and oxygenation profiles and leg hemodynamics of the common (CFA), superficial (SFA) and profunda (PFA) femoral arteries, and popliteal artery (POA) of the experimental and control legs were measured in healthy participants during: (1) 3 h of whole leg heating (WLH) followed by 3 h of recovery (n = 9); (2) 1 h of upper leg heating (ULH) followed by 30 min of cooling and 1 h ULH bout (n = 8); and (3) 1 h of lower leg heating (LLH) (n = 8). WLH increased experimental leg temperature by 4.2 ± 1.2ºC and blood flow in CFA, SFA, PFA, and POA by ≥3-fold, while the core temperature essentially remained stable. Upper and lower leg blood flow increased exponentially in response to leg temperature and then declined during recovery. ULH and LLH similarly increased the corresponding segmental leg temperature, blood flow, and tissue oxygenation without affecting these responses in the non-heated leg segment, or perfusion pressure and conduit artery diameter across all vessels. Findings demonstrate that whole leg hyperthermia induces profound and sustained elevations in upper and lower limb blood flow and that segmental hyperthermia matches the regional thermal hyperemia without causing thermal or hemodynamic alterations in the non-heated limb segment. These observations support the notion that heat-activated thermosensitive mechanisms in microcirculation regulate limb tissue perfusion during hyperthermia.
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Affiliation(s)
- Nuno Koch Esteves
- Centre for Human Performance, Exercise and RehabilitationCollege of Health, Medicine and Life SciencesBrunel University LondonUxbridgeUK
| | - Oliver R. Gibson
- Centre for Human Performance, Exercise and RehabilitationCollege of Health, Medicine and Life SciencesBrunel University LondonUxbridgeUK
- Division of Sport, Health and Exercise SciencesDepartment of Life SciencesCollege of Health, Medicine and Life SciencesBrunel University LondonUxbridgeUK
| | - Ashraf W. Khir
- Department of Mechanical and Aerospace EngineeringCollege of Engineering, Design and Physical SciencesBrunel University LondonUxbridgeUK
| | - José González‐Alonso
- Centre for Human Performance, Exercise and RehabilitationCollege of Health, Medicine and Life SciencesBrunel University LondonUxbridgeUK
- Division of Sport, Health and Exercise SciencesDepartment of Life SciencesCollege of Health, Medicine and Life SciencesBrunel University LondonUxbridgeUK
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Sauna dehydration as a new physiological challenge model for intestinal barrier function. Sci Rep 2021; 11:15514. [PMID: 34330970 PMCID: PMC8324874 DOI: 10.1038/s41598-021-94814-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/16/2021] [Indexed: 12/15/2022] Open
Abstract
The intestinal barrier plays a crucial role in maintaining gut health, and an increased permeability has been linked to several intestinal and extra-intestinal disorders. There is an increasing demand for interventions aimed at strengthening this barrier and for in vivo challenge models to assess their efficiency. This study investigated the effect of sauna-induced dehydration on intestinal barrier function (clinicaltrials.gov: NCT03620825). Twenty healthy subjects underwent three conditions in random order: (1) Sauna dehydration (loss of 3% body weight), (2) non-steroidal anti-inflammatory drug (NSAID) intake, (3) negative control. Intestinal permeability was assessed by a multi-sugar urinary recovery test, while intestinal damage, bacterial translocation and cytokines were assessed by plasma markers. The sauna dehydration protocol resulted in an increase in gastroduodenal and small intestinal permeability. Presumably, this increase occurred without substantial damage to the enterocytes as plasma intestinal fatty acid-binding protein (I-FABP) and liver fatty acid-binding protein (L-FABP) were not affected. In addition, we observed significant increases in levels of lipopolysaccharide-binding protein (LBP), IL-6 and IL-8, while sCD14, IL-10, IFN-ɣ and TNF-α were not affected. These results suggest that sauna dehydration increased intestinal permeability and could be applied as a new physiological in vivo challenge model for intestinal barrier function.
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Li Z, Jiang W, Salerno S, Li Y, Chen Y, Xu Z, Wang G. Acute Hemodynamic Improvement by Thermal Vasodilation inside the Abdominal and Iliac Arterial Segments of Young Sedentary Individuals. J Vasc Res 2021; 58:191-206. [PMID: 33823509 DOI: 10.1159/000514588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/19/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To study the hemodynamic response to lower leg heating intervention (LLHI) inside the abdominal and iliac arterial segments (AIAS) of young sedentary individuals. METHODS A Doppler measurement of blood flow was conducted for 5 young sedentary adults with LLHI. Heating durations of 0, 20, and 40 min were considered. A lumped parameter model (LPM) was used to ascertain the hemodynamic mechanism. The hemodynamics were determined via numerical approaches. RESULTS Ultrasonography revealed that the blood flow waveform shifted upwards under LLHI; in particular, the mean flow increased significantly (p < 0.05) with increasing heating duration. The LPM showed that its mechanism depends on the reduction in afterload resistance, not on the inertia of blood flow and arterial compliance. The time-averaged wall shear stress, time-averaged production rate of nitric oxide, and helicity in the external iliac arteries increased more significantly than in other segments as the heating duration increased, while the oscillation shear index (OSI) and relative residence time (RRT) in the AIAS declined with increasing heating duration. There was a more obvious helicity response in the bilateral external iliac arteries than the OSI and RRT responses. CONCLUSION LLHI can effectively induce a positive hemodynamic environment in the AIAS of young sedentary individuals.
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Affiliation(s)
- Zhongyou Li
- Laboratory of Biomechanical Engineering, Department of Applied Mechanics, College of Architecture & Environment, Sichuan University, Chengdu, China
| | - Wentao Jiang
- Laboratory of Biomechanical Engineering, Department of Applied Mechanics, College of Architecture & Environment, Sichuan University, Chengdu, China
| | - Stephen Salerno
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Yi Li
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Yu Chen
- Laboratory of Biomechanical Engineering, Department of Applied Mechanics, College of Architecture & Environment, Sichuan University, Chengdu, China
| | - Zhi Xu
- Laboratory of Biomechanical Engineering, Department of Applied Mechanics, College of Architecture & Environment, Sichuan University, Chengdu, China.,Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, China
| | - Guanshi Wang
- Laboratory of Biomechanical Engineering, Department of Applied Mechanics, College of Architecture & Environment, Sichuan University, Chengdu, China
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Brunt VE, Minson CT. Heat therapy: mechanistic underpinnings and applications to cardiovascular health. J Appl Physiol (1985) 2021; 130:1684-1704. [PMID: 33792402 DOI: 10.1152/japplphysiol.00141.2020] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Cardiovascular diseases (CVD) are the leading cause of death worldwide, and novel therapies are drastically needed to prevent or delay the onset of CVD to reduce the societal and healthcare burdens associated with these chronic diseases. One such therapy is "heat therapy," or chronic, repeated use of hot baths or saunas. Although using heat exposure to improve health is not a new concept, it has received renewed attention in recent years as a growing number of studies have demonstrated robust and widespread beneficial effects of heat therapy on cardiovascular health. Here, we review the existing literature, with particular focus on the molecular mechanisms that underscore the cardiovascular benefits of this practice.
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Affiliation(s)
- Vienna E Brunt
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado.,Department of Human Physiology, University of Oregon, Eugene, Oregon
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McCarty MF. Nutraceutical, Dietary, and Lifestyle Options for Prevention and Treatment of Ventricular Hypertrophy and Heart Failure. Int J Mol Sci 2021; 22:ijms22073321. [PMID: 33805039 PMCID: PMC8037104 DOI: 10.3390/ijms22073321] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/22/2021] [Accepted: 03/22/2021] [Indexed: 12/12/2022] Open
Abstract
Although well documented drug therapies are available for the management of ventricular hypertrophy (VH) and heart failure (HF), most patients nonetheless experience a downhill course, and further therapeutic measures are needed. Nutraceutical, dietary, and lifestyle measures may have particular merit in this regard, as they are currently available, relatively safe and inexpensive, and can lend themselves to primary prevention as well. A consideration of the pathogenic mechanisms underlying the VH/HF syndrome suggests that measures which control oxidative and endoplasmic reticulum (ER) stress, that support effective nitric oxide and hydrogen sulfide bioactivity, that prevent a reduction in cardiomyocyte pH, and that boost the production of protective hormones, such as fibroblast growth factor 21 (FGF21), while suppressing fibroblast growth factor 23 (FGF23) and marinobufagenin, may have utility for preventing and controlling this syndrome. Agents considered in this essay include phycocyanobilin, N-acetylcysteine, lipoic acid, ferulic acid, zinc, selenium, ubiquinol, astaxanthin, melatonin, tauroursodeoxycholic acid, berberine, citrulline, high-dose folate, cocoa flavanols, hawthorn extract, dietary nitrate, high-dose biotin, soy isoflavones, taurine, carnitine, magnesium orotate, EPA-rich fish oil, glycine, and copper. The potential advantages of whole-food plant-based diets, moderation in salt intake, avoidance of phosphate additives, and regular exercise training and sauna sessions are also discussed. There should be considerable scope for the development of functional foods and supplements which make it more convenient and affordable for patients to consume complementary combinations of the agents discussed here. Research Strategy: Key word searching of PubMed was employed to locate the research papers whose findings are cited in this essay.
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Affiliation(s)
- Mark F McCarty
- Catalytic Longevity Foundation, 811 B Nahant Ct., San Diego, CA 92109, USA
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Gravel H, Behzadi P, Cardinal S, Barry H, Neagoe PE, Juneau M, Nigam A, Sirois MG, Gagnon D. Acute Vascular Benefits of Finnish Sauna Bathing in Patients With Stable Coronary Artery Disease. Can J Cardiol 2021; 37:493-499. [DOI: 10.1016/j.cjca.2020.06.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/26/2020] [Accepted: 06/25/2020] [Indexed: 01/20/2023] Open
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Shepley BR, Ainslie PN, Hoiland RL, Donnelly J, Sekhon MS, Zetterberg H, Blennow K, Bain AR. Negligible influence of moderate to severe hyperthermia on blood-brain barrier permeability and neuronal parenchymal integrity in healthy men. J Appl Physiol (1985) 2021; 130:792-800. [PMID: 33444119 DOI: 10.1152/japplphysiol.00645.2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
With growing use for hyperthermia as a cardiovascular therapeutic, there is surprisingly little information regarding the acute effects it may have on the integrity of the neurovascular unit (NVU). Indeed, relying on animal data would suggest hyperthermia comparable to levels attained in thermal therapy will disrupt the blood-brain barrier (BBB) and damage the cerebral parenchymal cells. We sought to address the hypothesis that controlled passive hyperthermia is not sufficient to damage the NVU in healthy humans. Young men (n = 11) underwent acute passive heating until +2°C or absolute esophageal temperature of 39.5°C. The presence of BBB opening was determined by trans-cerebral exchange kinetics (radial-arterial and jugular venous cannulation) of S100B. Neuronal parenchymal damage was determined by the trans-cerebral exchange of tau protein, neuron-specific enolase (NSE), and neurofilament-light protein (NF-L). Cerebral blood flow to calculate exchange kinetics was measured by duplex ultrasound of the right internal carotid and left vertebral artery. Passive heating was performed via a warm-water perfused suit. In hyperthermia, there was no increase in the cerebral exchange of S100B (P = 0.327), tau protein (P = 0.626), NF-L (P = 0.447), or NSE (P = 0.908) suggesting the +2°C core temperature is not sufficient to acutely stress the NVU in healthy men. However, there was a significant condition effect (P = 0.028) of NSE, corresponding to a significant increase in arterial (P = 0.023) but not venous (P = 0.173) concentrations in hyperthermia, potentially indicating extra-cerebral release of NSE. Collectively, results from the present study support the notion that in young men there is little concern for NVU damage with acute hyperthermia of +2 °C.NEW & NOTEWORTHY The acute effects of passive whole-body hyperthermia on the integrity of the neurovascular unit (NVU) in humans have remained unclear. We demonstrate that passive heating for ∼1 h until an increase of +2°C esophageal temperature in healthy men does not increase the cerebral release of neuronal parenchymal stress biomarkers, suggesting the NVU integrity is maintained. This preliminary study indicates passive heating is safe for the brain, at least in young healthy men.
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Affiliation(s)
- Brooke R Shepley
- University of Windsor, Faculty of Human Kinetics, Department of Kinesiology, Windsor, ON, Canada
| | - Philip N Ainslie
- University of British Columbia, Kelowna, Centre for Heart Lung and Vascular Health, Vancouver, BC, Canada
| | - Ryan L Hoiland
- University of British Columbia, Kelowna, Centre for Heart Lung and Vascular Health, Vancouver, BC, Canada.,Department of Anesthesiology, Pharmacology, and Therapeutics, Vancouver General Hospital, Vancouver, BC, Canada
| | - Joseph Donnelly
- Brain Physics Laboratory, Division of Academic Neurosurgery, Department of Clinical Neurosciences, Addenbrookes Hospital, University of Cambridge, Cambridge, UK
| | - Mypinder S Sekhon
- University of British Columbia, Kelowna, Centre for Heart Lung and Vascular Health, Vancouver, BC, Canada.,Division of Critical Care Medicine and Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK.,UK Dementia Research Institute at UCL, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Anthony R Bain
- University of Windsor, Faculty of Human Kinetics, Department of Kinesiology, Windsor, ON, Canada
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Alali MH, Vianna LC, Lucas RAI, Junejo RT, Fisher JP. Impact of whole body passive heat stress and arterial shear rate modification on radial artery function in young men. J Appl Physiol (1985) 2020; 129:1373-1382. [PMID: 33031019 DOI: 10.1152/japplphysiol.00296.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We sought to determine how whole body heating acutely influences radial artery function, characterized using flow-mediated dilation (FMD) and low-flow-mediated constriction (L-FMC), and the mechanistic role of shear rate modification on radial artery functional characteristics during heating. Eleven young healthy men underwent whole body heating (water-perfused suit) sufficient to raise the core temperature by +1°C. Trials were repeated with (heat + WC) and without (heat) the application of a wrist cuff located distal to the radial artery examined, known to prevent increases in mean and anterograde shear rates but increase retrograde shear rate. Radial artery characteristics were assessed throughout each trial, with FMD and L-FMC assessed before and upon reaching the target core temperature. Heat markedly increased radial artery mean and anterograde shear rates, along with radial artery diameter and blood flow (P < 0.05). Heat + WC abolished the heat-induced increase in mean and anterograde shear rates (P > 0.05) but markedly increased retrograde shear rate (P < 0.05). Concomitantly, increases in radial artery diameter and blood flow were decreased (heat + WC vs. heat, P < 0.05). Heat attenuated FMD (8.6 ± 1.2% vs. 2.2 ± 1.4%, P < 0.05), whereas no change in FMD was observed in heat + WC (7.8 ± 1.2% vs. 10.8 ± 1.2%, P > 0.05). In contrast, L-FMC was not different in either trial (P > 0.05). In summary, acute whole body heating markedly elevates radial artery shear rate, diameter, and blood flow and diminishes FMD. However, marked radial artery vasodilation and diminished FMD are absent when these shear rate changes are prevented. Shear rate modifications underpin the radial artery response to acute whole body heat stress, but further endothelium-dependent vasodilation (FMD) is attenuated likely as the vasodilatory range limit is approached.NEW & NOTEWORTHY We observed that acute whole body heating elevates radial artery shear rate, diameter, and blood flow. This results in a diminished flow-meditated dilatation (FMD) but does not change low-flow-mediated constriction (L-FMC). Preventing shear rate changes during whole body heating reduces radial artery vasodilation and reverses FMD reductions but has no effect on L-FMC. These findings indicate that shear rate changes underpin conduit artery responses to acute whole body heat stress, but further endothelium-dependent flow-mediated vasodilation is attenuated as the vasodilatory range limit is approached.
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Affiliation(s)
- Mohammad H Alali
- School of Sport, Exercise & Rehabilitation Sciences, College of Life & Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Lauro C Vianna
- NeuroV̇ASQ̇ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, Distrito Federal, Brazil
| | - Rebekah A I Lucas
- School of Sport, Exercise & Rehabilitation Sciences, College of Life & Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Rehan T Junejo
- Department of Life Sciences, Manchester Metropolitan University, Manchester, United Kingdom.,Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, United Kingdom
| | - James P Fisher
- Faculty of Medical & Health Sciences, Department of Physiology, University of Auckland, Auckland, New Zealand
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Monroe JC, Lin C, Perkins SM, Han Y, Wong BJ, Motaganahalli RL, Roseguini BT. Leg heat therapy improves perceived physical function but does not enhance walking capacity or vascular function in patients with peripheral artery disease. J Appl Physiol (1985) 2020; 129:1279-1289. [PMID: 33002377 DOI: 10.1152/japplphysiol.00277.2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
A single session of leg heat therapy (HT) has been shown to elicit increases in leg blood flow and reduce blood pressure (BP) and the circulating levels of endothelin-1 (ET-1) in patients with symptomatic peripheral artery disease (PAD). We assessed whether 6 wk of supervised leg HT (3 times/wk) with water-circulating trousers perfused with water at 48°C improved 6-min walk distance in individuals with PAD compared with a sham treatment. Secondary outcomes included the assessment of leg vascular function, BP, quality of life, and serum ET-1 and nitrite plus nitrate (NOx) levels. Of 32 PAD patients randomized, 30 [age: 68 ± 8 yr; ankle-brachial index (ABI): 0.6 ± 0.1] completed the 3- and 6-wk follow-ups. Participants completed 98.7% of the treatment sessions. Compared with the sham treatment, exposure to HT did not improve 6-min walk distance, BP, popliteal artery reactive hyperemia, cutaneous microvascular reactivity, resting ABI, or serum NOx levels. The change from baseline to 6 wk in scores of the physical functioning subscale of the 36-item Short Form Health Survey was significantly higher in the HT group (control -6.9 ± 10 vs. HT 6.8 ± 15; 95% confidence interval: 2.5-24.3, P = 0.017). Similarly, the change in ET-1 levels after 6 wk was different between groups, with the HT group experiencing a 0.4 pg/mL decrease (95% confidence interval: -0.8-0.0, P = 0.03). These preliminary results indicate that leg HT may improve perceived physical function in symptomatic PAD patients. Additional, larger studies are needed to confirm these findings and determine the optimal treatment regimen for symptomatic PAD patients.NEW & NOTEWORTHY This is the first sham-controlled study to investigate the effects of leg heat therapy (HT) on walking performance, vascular function, and quality of life in patients with peripheral artery disease (PAD). Adherence to HT was high, and the treatment was well tolerated. Our findings revealed that HT applied with water-circulating trousers evokes a clinically meaningful increase in perceived physical function and reduces the serum concentration of the potent vasoconstrictor endothelin-1 in patients with PAD.
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Affiliation(s)
- Jacob C Monroe
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Chen Lin
- Department of Radiology, Mayo Clinic, Jacksonville, Florida
| | - Susan M Perkins
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Yan Han
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Brett J Wong
- Department of Kinesiology and Health, Georgia State University, Atlanta, Georgia
| | - Raghu L Motaganahalli
- Division of Vascular Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Bruno T Roseguini
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
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Wei J, Hollabaugh C, Miller J, Geiger PC, Flynn BC. Molecular Cardioprotection and the Role of Exosomes: The Future Is Not Far Away. J Cardiothorac Vasc Anesth 2020; 35:780-785. [PMID: 32571657 DOI: 10.1053/j.jvca.2020.05.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 01/20/2023]
Abstract
Heart disease is the leading cause of death in men and women in the United States. During the past several decades, research into the role of specific intracellular mediators, called exosomes, has advanced the understanding of molecular cardioprotection. Exosomes and the micro-RNAs within them may be potential targets for the development of genetically engineered or biosimilar medications for patients in heart failure or with ischemic cardiac disease. This review discusses anesthetic implications of exosome production and the future micro-RNA applications for cardioprotection.
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Affiliation(s)
- Johnny Wei
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS
| | | | - Joshua Miller
- University of Kansas Medical Center, Kansas City, KS
| | - Paige C Geiger
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS
| | - Brigid C Flynn
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS.
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Choi HS, Kwon H, Cho KH, Thuc LC, Park SY, Kim NH, Kim WJ, Kim YK, Jeon WS, Lee JA, Kim HC, Cho EH. Repeated Dry Sauna Therapy Improves Quality of Life in Obese Korean People. Korean J Fam Med 2020; 41:312-317. [PMID: 32434303 PMCID: PMC7509121 DOI: 10.4082/kjfm.18.0160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 11/22/2018] [Indexed: 12/31/2022] Open
Abstract
Background Dry sauna treatments improve the quality of life for chronic pain, congestive heart failure, and type 2 diabetes patients. This study aimed to determine whether dry sauna therapy improved the quality of life of obese people. Methods A total of 38 consecutive participants aged over 20 years with a body mass index of ≥25 kg/m2 were recruited for the study. The participants were treated with a 90°C dry sauna for 15 minutes, twice daily for 4 consecutive days. To assess the quality of life, all participants completed the 5 level EQ-5D questionnaires and the EQ-Visual Analog Scale. Study parameters were measured on the same day prior to commencing the sauna sessions in a fasted state and 2 days after the last sauna session. Results The average age was 62.3±9.5 years; 84.2% of the participants were female. The mean body mass index was 28.5±2.4 kg/m2. Dry sauna significantly improved the mean 5 level EQ-5D index scores from 0.83±0.12 to 0.89±0.11 and increased the mean EQ-Visual Analog Scale from 79.0±15.2 to 91.1±9.7. However, there were no significant changes in body mass index, blood pressure, heart rate, or body composition before and after the 8-session sauna therapy. Conclusion Dry sauna improved the health-related quality of life of obese patients without adverse events. Further clinical studies in larger study populations are needed to verify these findings and provide concrete evidence for obesity treatment.
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Affiliation(s)
- Hoon Sung Choi
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Hyuki Kwon
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Keun-Hyok Cho
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Le Cong Thuc
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - So Young Park
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Nam-Hun Kim
- College of Forest and Environmental Sciences, Kangwon National University, Chuncheon, Korea
| | - Wae-Jung Kim
- College of Forest and Environmental Sciences, Kangwon National University, Chuncheon, Korea
| | - Yun-Ki Kim
- College of Forest and Environmental Sciences, Kangwon National University, Chuncheon, Korea
| | - Woo-Seok Jeon
- College of Forest and Environmental Sciences, Kangwon National University, Chuncheon, Korea
| | - Ju-Ah Lee
- College of Forest and Environmental Sciences, Kangwon National University, Chuncheon, Korea
| | - Hyoung-Chun Kim
- Neuropsychopharmacology and Toxicology Program, College of Pharmacy, Kangwon National University, Chuncheon, Korea
| | - Eun-Hee Cho
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
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35
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Moore J, Kressler J, Buono MJ. Hand heating lowers postprandial blood glucose concentrations: A double-blind randomized controlled crossover trial. Complement Ther Med 2020; 49:102280. [PMID: 32147036 DOI: 10.1016/j.ctim.2019.102280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 11/30/2019] [Accepted: 12/11/2019] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES Examine effect of single hand heating with and without negative pressure on fasting blood glucose (FBG) and postprandial blood glucose (PBG). DESIGN Double-blind randomized controlled trial with crossover design. SUBJECTS FBG experiment: 17 healthy subjects (4 males). PBG experiment: 13 healthy subjects (1 males). INTERVENTIONS Devices included one providing heat only, one heat and negative pressure, and one acting as a sham. For the FBG experiment the devices were used for 30 min. For the PBG experiment the devices were used for one hour during an oral glucose tolerance test (OGTT). OUTCOME MEASURES Blood glucose measurements were used to determine change in FBG, peak PBG, area under the curve (AUC), and incremental AUC (iAUC). RESULTS Temperature: Change in tympanic temperature was ≤ 0.15 °C for all trials. FBG: There was no effect on FBG. PBG: Compared to the sham device the heat plus vacuum and heat only device lowered peak blood glucose by 16(31)mg/dL, p = 0.092 and 18(28)mg/dL, p = 0.039, respectively. AUC and iAUC: Compared to the sham device, the heat plus vacuum device and heat only device lowered the AUC by 5.1(15.0)%, p = 0.234 and 7.9(11.1)%, p = 0.024 respectively and iAUC by 17.2(43.4)%, p = 0.178 and 20.5(34.5)%, p = 0.054, respectively. CONCLUSIONS Heating a single hand lowers postprandial blood glucose in healthy subjects.
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Affiliation(s)
- Jeff Moore
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182-7251, United States.
| | - Jochen Kressler
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182-7251, United States.
| | - Michael J Buono
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182-7251, United States; Department of Biology, San Diego State University, San Diego, CA, 92182-7251, United States.
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Ye WN, Thipse M, Mahdi MB, Azad S, Davies R, Ruel M, Silver MA, Hakami L, Mesana T, Leenen F, Mussivand T. Can heat therapy help patients with heart failure? Artif Organs 2020; 44:680-692. [PMID: 32017138 DOI: 10.1111/aor.13659] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 12/16/2019] [Accepted: 01/30/2020] [Indexed: 12/17/2022]
Abstract
To review and analyze the clinical outcomes of thermal therapy (≤1.4°C increase in core body temperature) in patients with heart failure (HF). A systematic review and meta-analysis regarding the effects of thermal therapy on HF was done by searching PubMed, Ovid Medline, Ovid Embase, Scopus, and internal databases up to date (2019). Improvement in the New York Heart Association (NYHA) class: Ten studies with 310 patients showed significant improvement in NYHA class. Only 7 among 40 patients remained in Class IV and 99 patients in Class III from 155 patients. Increased patients in lower classes indicate that more patients showed improvement. Sixteen studies on 506 patients showed an overall improvement of 4.4% of left ventricular ejection fraction (LVEF). Four studies reported improved endothelial dysfunction by 1.7% increase in flow-mediated dilation (FMD) on 130 patients. Reduction in blood pressure: Thermal therapy reduced both systolic blood pressure (SBP) and diastolic blood pressure by 3.1% and 5.31%, respectively, in 431 patients of 15 studies. Decrease in cardiothoracic ratio (CTR): Eight studies reported an average of 5.55% reduction of CTR in a total of 347 patients. Improvement in oxidative stress markers: Plasma brain natriuretic peptide (BNP) levels significantly decreased (mean difference of 14.8 pg/dL) in 303 patients of 9 studies. Improvement of quality of life: Among 65 patients, thermal therapy reduced cardiac death and rehospitalization by 31.3%. A slight increase in core body temperature is a promising, noninvasive, effective, and complementary therapy for patients with HF. Further clinical studies are recommended.
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Affiliation(s)
- Winnie N Ye
- Department of Electronics, Carleton University, Ottawa, ON, Canada
| | - Madhura Thipse
- Cardiovascular Devices Division, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Maleka Ben Mahdi
- Cardiovascular Devices Division, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Sharlin Azad
- Cardiovascular Devices Division, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Ross Davies
- Cardiovascular Devices Division, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Marc Ruel
- Cardiovascular Devices Division, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Marc A Silver
- Heart Failure Institute, Advocate Christ Medical Centre, Oak Lawn, IL, USA
| | - Lale Hakami
- Medical Center, University of Munich, Munich, Germany
| | - Thierry Mesana
- Cardiovascular Devices Division, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Frans Leenen
- Cardiovascular Devices Division, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Tofy Mussivand
- Cardiovascular Devices Division, University of Ottawa Heart Institute, Ottawa, ON, Canada
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Li Z, Jiang W, Chen Y, Wang G, Yan F, Zeng T, Fan H. Acute and short-term efficacy of sauna treatment on cardiovascular function: A meta-analysis. Eur J Cardiovasc Nurs 2020; 20:96-105. [PMID: 32814462 DOI: 10.1177/1474515120944584] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The role of sauna bathing in cardiovascular function treatment has been increasingly explored, but insufficient attention has been paid to its efficacy. We performed a meta-analysis to provide more evidence for the efficacy of sauna treatment in cardiovascular nursing. METHODS Sixteen peer-reviewed journal articles were screened to summarize the efficacy of the sauna on cardiovascular function. Both acute (0-30 min after the sauna) and short-term (2-4 weeks following the sauna treatment) efficacies were investigated. RESULTS For pooled acute efficacy, body temperature and heart rate significantly (p<0.001) grew by 0.94℃ and 17.86 beats/min, respectively; reductions of 5.55 mmHg (p<0.001) and 6.50 mmHg (p<0.001) were also observed in systolic blood pressure and diastole blood pressure, respectively. For combined short-term efficacy, left ventricular ejection fraction (LVEF), 6-min walk distance, and flow-mediated dilation (p<0.001) increased by 3.27%, 48.11 m, and 1.71%, respectively; greater amelioration in LVEF was observed in participants with lower LVEF. The proportion of patients with New York Heart Association class III and IV decreased by 10.9% and 12.2%, respectively. Systolic blood pressure, diastolic blood pressure, brain natriuretic peptide concentration, left ventricular end-diastolic dimension, cardiothoracic ratio, and left atrial dimension reduced by 5.26 mmHg (p<0.001), 4.14 mmHg (p<0.001), 116.66 pg/mL (p<0.001), 2.79 mm (p<0.001), 2.628% (p<0.05), and 1.88 mm (p<0.05), respectively, while the concentration of norepinephrine in the plasma remained unchanged. CONCLUSION Sauna treatment was found to play a positive role in improving cardiovascular function and physical activity levels, especially in patients with low cardiovascular function. These findings reveal that thermal intervention may be a promising means for cardiovascular nursing.
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Affiliation(s)
- Zhongyou Li
- Laboratory of Biomechanical Engineering, Department of Applied Mechanics, College of Architecture & Environment, Sichuan University, Chengdu, China
| | - Wentao Jiang
- Laboratory of Biomechanical Engineering, Department of Applied Mechanics, College of Architecture & Environment, Sichuan University, Chengdu, China
| | - Yu Chen
- Laboratory of Biomechanical Engineering, Department of Applied Mechanics, College of Architecture & Environment, Sichuan University, Chengdu, China
| | - Guanshi Wang
- Laboratory of Biomechanical Engineering, Department of Applied Mechanics, College of Architecture & Environment, Sichuan University, Chengdu, China
| | - Fei Yan
- Laboratory of Biomechanical Engineering, Department of Applied Mechanics, College of Architecture & Environment, Sichuan University, Chengdu, China
- Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Tao Zeng
- Laboratory of Biomechanical Engineering, Department of Applied Mechanics, College of Architecture & Environment, Sichuan University, Chengdu, China
| | - Haidong Fan
- Laboratory of Biomechanical Engineering, Department of Applied Mechanics, College of Architecture & Environment, Sichuan University, Chengdu, China
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Kim K, Reid BA, Casey CA, Bender BE, Ro B, Song Q, Trewin AJ, Petersen AC, Kuang S, Gavin TP, Roseguini BT. Effects of repeated local heat therapy on skeletal muscle structure and function in humans. J Appl Physiol (1985) 2020; 128:483-492. [PMID: 31971474 DOI: 10.1152/japplphysiol.00701.2019] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The purpose of the present study was to examine the effects of repeated exposure to local heat therapy (HT) on skeletal muscle function, myofiber morphology, capillarization, and mitochondrial content in humans. Twelve young adults (23.6 ± 4.8 yr, body mass index 24.9 ± 3.0 kg/m2) had one randomly selected thigh treated with HT (garment perfused with water at ~52°C) for 8 consecutive weeks (90 min, 5 days/wk) while the opposite thigh served as a control. Biopsies were obtained from the vastus lateralis muscle before and after 4 and 8 wk of treatment. Knee extensor strength and fatigue resistance were also assessed using isokinetic dynamometry. The changes in peak isokinetic torque were higher (P = 0.007) in the thigh exposed to HT than in the control thigh at weeks 4 (control 4.2 ± 13.1 Nm vs. HT 9.1 ± 16.1 Nm) and 8 (control 1.8 ± 9.7 Nm vs. HT 7.8 ± 10.2 Nm). Exposure to HT averted a temporal decline in capillarization around type II fibers (P < 0.05), but had no effect on capillarization indexes in type I fibers. The content of endothelial nitric oxide synthase was ~18% and 35% higher in the thigh exposed to HT at 4 and 8 wk, respectively (P = 0.003). Similarly, HT increased the content of small heat shock proteins HSPB5 (P = 0.007) and HSPB1 (P = 0.009). There were no differences between thighs for the changes in fiber cross-sectional area and mitochondrial content. These results indicate that exposure to local HT for 8 wk promotes a proangiogenic environment and enhances muscle strength but does not affect mitochondrial content in humans.NEW & NOTEWORTHY We demonstrate that repeated application of heat therapy to the thigh with a garment perfused with warm water enhances the strength of knee extensors and influences muscle capillarization in parallel with increases in the content of endothelial nitric oxide synthase and small heat shock proteins. This practical method of passive heat stress may be a feasible tool to treat conditions associated with capillary rarefaction and muscle weakness.
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Affiliation(s)
- Kyoungrae Kim
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Blake A Reid
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Caitlin A Casey
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Brooke E Bender
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Bohyun Ro
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Qifan Song
- Department of Statistics, Purdue University, West Lafayette, Indiana
| | - Adam J Trewin
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Aaron C Petersen
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Shihuan Kuang
- Department of Animal Sciences, Purdue University, West Lafayette, Indiana
| | - Timothy P Gavin
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Bruno T Roseguini
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
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Hunt AP, Minett GM, Gibson OR, Kerr GK, Stewart IB. Could Heat Therapy Be an Effective Treatment for Alzheimer's and Parkinson's Diseases? A Narrative Review. Front Physiol 2020; 10:1556. [PMID: 31998141 PMCID: PMC6965159 DOI: 10.3389/fphys.2019.01556] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 12/10/2019] [Indexed: 12/11/2022] Open
Abstract
Neurodegenerative diseases involve the progressive deterioration of structures within the central nervous system responsible for motor control, cognition, and autonomic function. Alzheimer's disease and Parkinson's disease are among the most common neurodegenerative disease and have an increasing prevalence over the age of 50. Central in the pathophysiology of these neurodegenerative diseases is the loss of protein homeostasis, resulting in misfolding and aggregation of damaged proteins. An element of the protein homeostasis network that prevents the dysregulation associated with neurodegeneration is the role of molecular chaperones. Heat shock proteins (HSPs) are chaperones that regulate the aggregation and disaggregation of proteins in intracellular and extracellular spaces, and evidence supports their protective effect against protein aggregation common to neurodegenerative diseases. Consequently, upregulation of HSPs, such as HSP70, may be a target for therapeutic intervention for protection against neurodegeneration. A novel therapeutic intervention to increase the expression of HSP may be found in heat therapy and/or heat acclimation. In healthy populations, these interventions have been shown to increase HSP expression. Elevated HSP may have central therapeutic effects, preventing or reducing the toxicity of protein aggregation, and/or peripherally by enhancing neuromuscular function. Broader physiological responses to heat therapy have also been identified and include improvements in muscle function, cerebral blood flow, and markers of metabolic health. These outcomes may also have a significant benefit for people with neurodegenerative disease. While there is limited research into body warming in patient populations, regular passive heating (sauna bathing) has been associated with a reduced risk of developing neurodegenerative disease. Therefore, the emerging evidence is compelling and warrants further investigation of the potential benefits of heat acclimation and passive heat therapy for sufferers of neurodegenerative diseases.
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Affiliation(s)
- Andrew P. Hunt
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Geoffrey M. Minett
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Oliver R. Gibson
- Centre for Human Performance, Exercise and Rehabilitation, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Graham K. Kerr
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Ian B. Stewart
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
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Tan CCS, Chin LKK, Low ICC. Thermoregulation in the Aging Population and Practical Strategies to Overcome a Warmer Tomorrow. Proteomics 2019; 20:e1800468. [PMID: 31652021 DOI: 10.1002/pmic.201800468] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 09/05/2019] [Indexed: 12/11/2022]
Abstract
As global temperatures continue to rise, improving thermal tolerance in the aged population is crucial to counteract age-associated impairments in thermoregulatory function. Impairments in reflex cutaneous vasodilation and sweating response can augment the vulnerability of older adults to heat-related injuries following exposure to heat stress. Mechanisms underlying a compromised cutaneous vasodilation are suggested to include reduced sympathetic neural drive, diminished cholinergic co-transmitter contribution, and altered second messenger signaling events. On the other hand, impairments in sweating response are ascribed to reduced sweat gland cholinergic sensitivity and altered cyclooxygenase and nitric oxide signaling. Several practical mitigation strategies such as exercise, passive heating, and behavioral adaptations are proposed as means to overcome heat stress and improve thermal tolerance in the aged. Aerobic exercise training is shown to be amongst the most effective ways to enhance thermoregulatory function. However, in elderly with limited exercise capability due to chronic diseases and mobility issues, passive heating can serve as a functional alternative as it has been shown to confer similar benefits to that of exercise training. Supplementary to exercise training and passive heating, behavioral adaptations can be applied to further enhance the heat-preparedness of the aged.
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Affiliation(s)
- Chee Chong Shawn Tan
- Department of Physiology, Yong Loo Lin School of Medicine (YLLSoM), National University of Singapore (NUS), Singapore, 117593, Singapore
| | - Li Kang Karen Chin
- Department of Physiology, Yong Loo Lin School of Medicine (YLLSoM), National University of Singapore (NUS), Singapore, 117593, Singapore
| | - Ivan Cherh Chiet Low
- Department of Physiology, Yong Loo Lin School of Medicine (YLLSoM), National University of Singapore (NUS), Singapore, 117593, Singapore
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Sauna bathing reduces the risk of venous thromboembolism: a prospective cohort study. Eur J Epidemiol 2019; 34:983-986. [PMID: 31372865 DOI: 10.1007/s10654-019-00544-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 07/26/2019] [Indexed: 10/26/2022]
Abstract
Emerging evidence suggests there is an inverse and independent association between sauna bathing and arterial thrombotic disease. However, the potential association between sauna bathing and venous thromboembolism (VTE) has not yet been investigated. We aimed to assess the prospective association between frequency of sauna bathing and the risk of VTE. Baseline sauna bathing habits were assessed in 2242 men aged 42-61 years without a history of VTE in the Kuopio Ischemic Heart Disease prospective cohort. Cox proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for VTE. During a median follow-up of 24.9 years, 146 (6.5%) incident VTE events were recorded. In age-adjusted analyses, the HRs 95% (CIs) of VTE were 0.67 (0.47-0.96) and 0.95 (0.53-1.70) for participants who had 2-3 and ≥ 4 sauna sessions per week respectively compared with participants who had ≤ 1 sauna session per week. After further adjustment for several established risk factors including lifestyle factors, the corresponding HRs (95% CIs) were 0.67 (0.46-0.96) and 0.92 (0.51-1.68) respectively. Having sauna baths was associated with a reduced risk of VTE in a middle-aged male Caucasian population. Further studies in other populations and age groups are required to confirm these findings.
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Laukkanen JA, Kunutsor SK. Is sauna bathing protective of sudden cardiac death? A review of the evidence. Prog Cardiovasc Dis 2019; 62:288-293. [PMID: 31102597 DOI: 10.1016/j.pcad.2019.05.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 05/04/2019] [Indexed: 10/26/2022]
Abstract
Sudden cardiac death (SCD) is a global public health burden accounting for 15-20% of all deaths. Though established atherosclerotic risk factors explain a large proportion of the risk of SCD, these factors are often absent in a large proportion of SCD victims and the pathogenesis of SCD is still not fully established. It therefore appears that additional factors may be involved. Sauna bathing is a traditional Finnish activity that is mainly used for the purposes of relaxation and pleasure. Beyond its use for these purposes, sauna bathing has been linked with several health benefits. Emerging evidence suggests that sauna bathing is associated with reduced risk of adverse cardiovascular (CV) disease (CVD) and non-CVD outcomes as well as mortality. A number of reports have linked sauna bathing with reduced or increased risk of SCD, but the evidence is uncertain. This review summarizes available studies linking sauna bathing with SCD, the postulated mechanistic pathways underlying these associations, outlines areas of outstanding uncertainty, and the implications for prevention. We employed a comprehensive search for observational studies, randomized controlled trials (RCTs), and non-RCTs from MEDLINE and Embase since their inception until March 2019. Observational data suggest that regular sauna bathing is associated with a substantial risk reduction in SCD. Furthermore, the data suggest that a combination of regular physical activity and sauna baths confers substantial risk reduction for SCD compared with either modality alone. Few reports have linked sauna baths with SCDs, but these single case incidents have been attributed to the effects of dehydration, hypotension, and cardiac arrhythmias due to a combination of sauna exposure and alcohol consumption. Sauna bathing is generally safe for most healthy people and even among patients with stable CVD, if used sensibly and with caution. Plausible pathways underlying the protective effect of sauna bathing on SCD may be linked to the impact on CV function via reduced arterial stiffness, decreases in inflammation and oxidative stress, stabilization of the autonomic nervous system, beneficial changes in circulating lipid profiles and other CVD risk markers, and lowering of systemic blood pressure. Sauna is a potential novel tool to promote SCD prevention in addition to other known means, being an enjoyable way to take care of general health and well-being.
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Affiliation(s)
- Jari A Laukkanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland; Central Finland Healthcare District, Department of Internal Medicine, Jyväskylä, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
| | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK; Translational Health Sciences, Bristol Medical School, Musculoskeletal Research Unit, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, UK
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Brunt VE, Weidenfeld-Needham KM, Comrada LN, Francisco MA, Eymann TM, Minson CT. Serum from young, sedentary adults who underwent passive heat therapy improves endothelial cell angiogenesis via improved nitric oxide bioavailability. Temperature (Austin) 2019; 6:169-178. [PMID: 31286027 PMCID: PMC6601412 DOI: 10.1080/23328940.2019.1614851] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 04/26/2019] [Accepted: 05/01/2019] [Indexed: 12/25/2022] Open
Abstract
Rationale: Passive heat therapy improves vascular endothelial function, likely via enhanced nitric oxide (NO) bioavailability, although the mechanistic stimuli driving these changes are unknown. Objective: To determine the isolated effects of circulating (serum) factors on endothelial cell function, particularly angiogenesis, and NO bioavailability. Methods and Results: Cultured human umbilical vein endothelial cells (HUVECs) were exposed to serum collected from 20 healthy young (22 ± 1 years) adults before (0 wk), after one session of water immersion (Acute HT), and after 8 wk of either heat therapy (N = 10; 36 sessions of hot water immersion; session 1 peak rectal temperature: 39.0 ± 0.03°C) or sham (N = 10; 36 sessions of thermoneutral water immersion). Serum collected following acute heat exposure and heat therapy improved endothelial cell angiogenesis (Matrigel bioassay total tubule length per frame, 0 wk: 69.3 ± 1.9 mm vs. Acute HT: 72.8 ± 1.4 mm, p = 0.04; vs. 8 wk: 73.0 ± 1.4 mm, p = 0.03), with no effects of sham serum. Enhanced angiogenesis was NO-mediated, as addition of the NO synthase (NOS) inhibitor L-NNA to the culture media abolished differences in tubule formation across conditions (0 wk: 71.3 ± 1.8 mm, Acute HT: 71.6 ± 1.9 mm, 8 wk: 70.5 ± 1.6 mm, p = 0.69). In separate experiments, we found that abundance of endothelial NOS (eNOS) was unaffected by Acute HT serum (p = 0.71), but increased by 8 wk heat therapy serum (1.4 ± 0.1-fold from 0 wk, p < 0.01). Furthermore, increases in eNOS were related to improvements in endothelial tubule formation (r2 = 0.61, p < 0.01). Conclusions: Passive heat therapy beneficially alters circulating factors that promote NO-mediated angiogenesis in endothelial cells and increase eNOS abundance. These changes may contribute to improvements in vascular function with heat therapy observed in vivo. Abbreviations: Ang-1: angiopoietin-1; ANOVA: analysis of variance; bFGF: basic fibroblast growth factor; CV: cardiovascular; CVD: cardiovascular diseases; eNOS: endothelial nitric oxide synthase; HSPs: heat shock proteins; HT: heat therapy; HUVECs: human umbilical endothelial cells; L-NNA: Nω-nitro-L-arginine; MnSOD: manganese superoxide dismutase; NO: nitric oxide; NOS: nitric oxide synthase; PBMCs: peripheral blood mononuclear cells; RM: repeated measures; sFlt-1: soluble VEGF receptor; SOD: superoxide dismutase; TGF-β: transforming growth factor- β; VEGF: vascular endothelial growth factor.
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Affiliation(s)
- Vienna E. Brunt
- Department of Human Physiology, University of Oregon, Eugene, OR, USA
| | | | - Lindan N. Comrada
- Department of Human Physiology, University of Oregon, Eugene, OR, USA
| | | | - Taylor M. Eymann
- Department of Human Physiology, University of Oregon, Eugene, OR, USA
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The blood pressure and heart rate during sauna bath correspond to cardiac responses during submaximal dynamic exercise. Complement Ther Med 2019; 44:218-222. [PMID: 31126559 DOI: 10.1016/j.ctim.2019.05.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 04/29/2019] [Accepted: 05/01/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES In the present study, the reaction of blood pressure and heart rate are examined during and after a single acute sauna application. DESIGN In 19 healthy adult volunteers (7 women, aged 46.4±10.2 years, BMI 24.4±2 kg /m2), blood pressure (BP) and heart rate (HR) were measured during a 25-minute sauna session (93°C, 13 % humidity) and during a subsequent 30-minute rest period. The parameters obtained were compared with the BP and HR responses during submaximal dynamic exercise testing. RESULTS The heat exposure resulted in a significant (p<0.01) and progressive increase in systolic and diastolic BP. After the sauna bath, BP decreased and showed significantly (p<0.001) lower values compared to baseline. HR also increased continuously during heat application (p<0.001), resulting in a significant increase (p<0.001) in systolic BP x HR as a measure of myocardial oxygen consumption. After the end of the sauna session, both the BP and the HR decreased steadily (p<0.001).When comparing BP and HR during the sauna session with the reaction during a dynamic exercise test, sauna bathing was equivalent to an exercise load of about 60-100 watts. CONCLUSIONS Contrary to popular belief, acute sauna use does not lead to a reduction, but to an increase in BP and HR with a consequent increase in myocardial oxygen consumption. The cardiac load during the sauna use corresponds to a moderate physical load of 60-100 watts.
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Abstract
In addition to its role as an environmental stressor, scientists have recently demonstrated the potential for heat to be a therapy for improving or mitigating declines in arterial health. Many studies at both ends of the scientific controls spectrum (tightly controlled, experimental vs. practical) have demonstrated the beneficial effects of heating on microvascular function (e.g., reactive hyperemia, cutaneous vascular conductance); endothelial function (e.g., flow-mediated dilation); and arterial stiffness (e.g., pulse-wave velocity, compliance, β-stiffness index). It is important to note that findings of beneficial effects are not unanimous, likely owing to the varied methodology in both heating protocols and assessments of outcome measures. Mechanisms of action for the effects of both acute and chronic heating are also understudied. Heat science is a very promising area of human physiology research, as it has the potential to contribute to approaches addressing the global cardiovascular disease burden, particularly in aging and at risk populations, and those for whom exercise is not feasible or recommended.
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Affiliation(s)
- Jem L Cheng
- Department of Kinesiology, McMaster University , Hamilton, Ontario , Canada
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Laukkanen T, Kunutsor SK, Khan H, Willeit P, Zaccardi F, Laukkanen JA. Sauna bathing is associated with reduced cardiovascular mortality and improves risk prediction in men and women: a prospective cohort study. BMC Med 2018; 16:219. [PMID: 30486813 PMCID: PMC6262976 DOI: 10.1186/s12916-018-1198-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 10/26/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Previous evidence indicates that sauna bathing is related to a reduced risk of fatal cardiovascular disease (CVD) events in men. The aim of this study was to investigate the relationship between sauna habits and CVD mortality in men and women, and whether adding information on sauna habits to conventional cardiovascular risk factors is associated with improvement in prediction of CVD mortality risk. METHODS Sauna bathing habits were assessed at baseline in a sample of 1688 participants (mean age 63; range 53-74 years), of whom 51.4% were women. Multivariable-adjusted hazard ratios (HRs) were calculated to investigate the relationships of frequency and duration of sauna use with CVD mortality. RESULTS A total of 181 fatal CVD events occurred during a median follow-up of 15.0 years (interquartile range, 14.1-15.9). The risk of CVD mortality decreased linearly with increasing sauna sessions per week with no threshold effect. In age- and sex-adjusted analysis, compared with participants who had one sauna bathing session per week, HRs (95% CIs) for CVD mortality were 0.71 (0.52 to 0.98) and 0.30 (0.14 to 0.64) for participants with two to three and four to seven sauna sessions per week, respectively. After adjustment for established CVD risk factors, potential confounders including physical activity, socioeconomic status, and incident coronary heart disease, the corresponding HRs (95% CIs) were 0.75 (0.52 to 1.08) and 0.23 (0.08 to 0.65), respectively. The duration of sauna use (minutes per week) was inversely associated with CVD mortality in a continuous manner. Addition of information on sauna bathing frequency to a CVD mortality risk prediction model containing established risk factors was associated with a C-index change (0.0091; P = 0.010), difference in - 2 log likelihood (P = 0.019), and categorical net reclassification improvement (4.14%; P = 0.004). CONCLUSIONS Higher frequency and duration of sauna bathing are each strongly, inversely, and independently associated with fatal CVD events in middle-aged to elderly males and females. The frequency of sauna bathing improves the prediction of the long-term risk for CVD mortality.
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Affiliation(s)
- Tanjaniina Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FIN-70211, Kuopio, Finland.,Central Finland Health Care District, Jyväskylä, Finland
| | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK.,Translational Health Sciences, Bristol Medical School, Musculoskeletal Research Unit, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, UK
| | - Hassan Khan
- Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA, USA
| | - Peter Willeit
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.,Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Francesco Zaccardi
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
| | - Jari A Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FIN-70211, Kuopio, Finland. .,Central Finland Health Care District, Jyväskylä, Finland. .,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
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Shemilt R, Bagabir H, Lang C, Khan F. Potential mechanisms for the effects of far-infrared on the cardiovascular system - a review. VASA 2018; 48:303-312. [PMID: 30421656 DOI: 10.1024/0301-1526/a000752] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Far-infrared (FIR) is a form of thermal radiation, which may have beneficial effects on cardiovascular health. Clinical studies suggest that FIR irradiation may have therapeutic effects in heart failure, myocardial ischaemia and may improve flow and survival of arteriovenous fistula. Animal studies have suggested a wide range of potential mechanisms involving endothelial nitric oxide synthase and nitric oxide bioavailability, oxidative stress, heat shock proteins and endothelial precursor cells. However, the exact cellular and molecular mechanism of FIR on the cardiovascular system remains elusive. The purpose of this review is to discuss the current literature, focusing on mechanistic studies involving the cardiovascular system, and with a view to highlighting areas for future investigation.
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Affiliation(s)
- Richard Shemilt
- 1 Division of Molecular and Clinical Medicine, University of Dundee
| | - Hala Bagabir
- 1 Division of Molecular and Clinical Medicine, University of Dundee
| | - Chim Lang
- 1 Division of Molecular and Clinical Medicine, University of Dundee
| | - Faisel Khan
- 1 Division of Molecular and Clinical Medicine, University of Dundee
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48
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Manjuladevi T, Mooventhan A, Manjunath N. Immediate effect of hot chest pack on cardio-respiratory functions in healthy volunteers: A randomized cross-over study. ADVANCES IN INTEGRATIVE MEDICINE 2018. [DOI: 10.1016/j.aimed.2017.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Laukkanen JA, Laukkanen T, Kunutsor SK. Cardiovascular and Other Health Benefits of Sauna Bathing: A Review of the Evidence. Mayo Clin Proc 2018; 93:1111-1121. [PMID: 30077204 DOI: 10.1016/j.mayocp.2018.04.008] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 03/27/2018] [Accepted: 04/02/2018] [Indexed: 11/20/2022]
Abstract
Sauna bathing, an activity that has been a tradition in Finland for thousands of years and mainly used for the purposes of pleasure and relaxation, is becoming increasingly popular in many other populations. Emerging evidence suggests that beyond its use for pleasure, sauna bathing may be linked to several health benefits, which include reduction in the risk of vascular diseases such as high blood pressure, cardiovascular disease, and neurocognitive diseases; nonvascular conditions such as pulmonary diseases; mortality; as well as amelioration of conditions such as arthritis, headache, and flu. The beneficial effects of sauna bathing on these outcomes have been linked to its effect on circulatory, cardiovascular, and immune functions. It has been postulated that regular sauna bathing may improve cardiovascular function via improved endothelium-dependent dilatation, reduced arterial stiffness, modulation of the autonomic nervous system, beneficial changes in circulating lipid profiles, and lowering of systemic blood pressure. This review summarizes the available epidemiological, experimental, and interventional evidence linking Finnish sauna bathing and its effects on cardiovascular outcomes and other disease conditions on the basis of a comprehensive search for observational studies, randomized controlled trials, and non-randomized controlled trials from MEDLINE and EMBASE from their inception until February 24, 2018. An overview of the postulated biological mechanisms underlying the associations between sauna bathing and its health benefits, areas of outstanding uncertainty, and implications for clinical practice is also provided.
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Affiliation(s)
- Jari A Laukkanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland; Department of Internal Medicine, Central Finland Health Care District, Jyväskylä, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
| | - Tanjaniina Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University of Bristol, Bristol, United Kingdom; Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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Short-term effects of Finnish sauna bathing on blood-based markers of cardiovascular function in non-naive sauna users. Heart Vessels 2018; 33:1515-1524. [PMID: 29971466 PMCID: PMC6267405 DOI: 10.1007/s00380-018-1202-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 06/15/2018] [Indexed: 12/15/2022]
Abstract
Emerging evidence suggests that sauna bathing is associated with reduced risk of cardiovascular and all-cause mortality events. However, the biochemical pathways by which sauna bathing might confer its effects on cardiovascular function are not certain. We aimed to study the acute effects of Finnish sauna bathing on various blood-based cardiovascular biomarkers. The study included 102 non-naive sauna users (54% male) with mean age of 51.9 years, who had at least one cardiovascular risk factor. Participants underwent a 30-min single sauna session (mean temperature, 73 °C). Biochemical profiling was conducted before, immediately after sauna and 30-min post-sauna. Overall median N-terminal pro-B-type natriuretic peptide (NT-proBNP) level (n = 20 participants) was 46.0 ng/L before sauna exposure, which increased to 50.5 ng/l immediately after sauna (median change, + 12.00%; p < 0.001) and remained persistent at 30-min post-sauna (median change from pre-sauna to post-30-min sauna, + 13.93%; p < 0.001). The changes were more evident in males compared with females. There were no significant changes in overall levels of high sensitivity C-reactive protein, creatine kinase, high sensitivity troponin I, and creatine kinase-MBm. However, levels of creatine kinase increased in males (median change immediately after sauna, + 2.99%; p = 0.024). Levels of NT-proBNP increased after sauna exposure. The increase in levels of creatine kinase was more evident in males. Long-term interventional studies are warranted to evaluate if these biomarkers are involved in pathways underlying the associations of sauna bathing with cardiovascular outcomes.
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