Waon Therapy for Managing Chronic Heart Failure　– Results From a Multicenter Prospective Randomized WAON-CHF Study –

Abstract

Background: Waon therapy improves heart failure (HF) symptoms, but further evidence in patients with advanced HF remains uncertain. Methods and Results:In 19 institutes, we prospectively enrolled hospitalized patients with advanced HF, who had plasma levels of B-type natriuretic peptide (BNP) >500 pg/ml on admission and BNP >300 pg/ml regardless of more than 1 week of medical therapy. Enrolled patients were randomized into Waon therapy or control groups. Waon therapy was performed once daily for 10 days with a far infrared-ray dry sauna maintained at 60°C for 15 min, followed by bed rest for 30 min covered with a blanket. The primary endpoint was the ratio of BNP before and after treatment. In total, 76 Waon therapy and 73 control patients (mean age 66 years, men 61%, mean plasma BNP 777 pg/ml) were studied. The groups differed only in body mass index and the frequency of diabetes. The plasma BNP, NYHA classification, 6-min walk distance (6MWD), and cardiothoracic ratio significantly improved only in the Waon therapy group. Improvements in NYHA classification, 6MWD, and cardiothoracic ratio were significant in the Waon therapy group, although the change in plasma BNP did not reach statistical significance. No serious adverse events were observed in either group. Conclusions:Waon therapy, a holistic soothing warmth therapy, showed clinical advantages in safety and efficacy among patients with advanced HF. (Circ J 2016; 80: 827 -834)

Renin-Angiotensin-Aldosterone System and Natriuretic Peptides as Possible Targets of Waon Therapy in Heart Failure

“…8 Impaired NO-mediated vasodilation is potentially attributable to activation of the RAAS and NPs, as well as to oxidative stress and sympathetic nervous system activity. As such, this clinical study further implicates the possible link between Waon therapy and modulation of the RAAS and NP systems in the context of HF (Figure).…”

Neurohumoral Modulation During Waon Therapy in Chronic Heart Failure ― Subanalysis of Waon-CHF Study ―

“…3,5,6,9,13, 14 Most recently, we reported a phase III clinical trial of the safety and efficacy of Waon therapy in a multicenter, randomized study (WAON-CHF Study). 15 NYHA classification, 6-min walk distance, and cardiothoracic ratio were significantly improved in the Waon therapy group compared with the control group and BNP levels improved, but not significantly. 15 In the current study as a subanalysis of WAON-CHF Study, we sought to determine whether neurohumoral factors related to the RAAS and NP systems were modulated by Waon therapy.…”

“…15 NYHA classification, 6-min walk distance, and cardiothoracic ratio were significantly improved in the Waon therapy group compared with the control group and BNP levels improved, but not significantly. 15 In the current study as a subanalysis of WAON-CHF Study, we sought to determine whether neurohumoral factors related to the RAAS and NP systems were modulated by Waon therapy. Specifically, we selected 3 biomarkers: BNP, which is For comparison of post-treatment values between subgroups of interest, analysis of covariance was used.…”

“…15 The ethics committee of each center approved the study protocol. Written informed consent was given by all participants before enrollment.…”

“…Patients taking anticoagulant agents had reduced post-BNP levels compared with patients without such treatments in the control group (P=0.02), but there was no difference in post-BNP levels with or without anticoagulants in the Waon group. In the Waon group, post-BNP levels were significantly lower in patients taking ACEI/ARB (P=0.001), and tended to be lower with spironolactone (P=0.07) compared with Table 1 shows the patients' characteristics which are additionally used for the current analysis from a previous report, 15 including detailed information on medications that possibly affected circulating neurohumoral factors, such as angiotensin-converting enzyme inhibitor (ACEI)/ angiotensin-receptor blocker (ARB), diuretics, human recombinant atrial NP (hANP, carperitide), and β-blockers. There was no significant difference between the groups with regard to these medications.…”