Objectives: The purpose of this study was to examine the beneficial effects of balneotherapy in patients with chronic heart failure (CHF).
Background: Some reports have shown that balneotherapy reduces systemic blood pressure in healthy volunteers. However, it is not clear whether balneotherapy improves the status of CHF. We hypothesized that hyperthermia using hot water would improve cardiac and peripheral endothelial function and clinical symptoms.
Methods: Twenty-six patients with chronic systolic heart failure classified as New York Heart Association (NYHA) functional status II or III were divided into two groups. In the balneotherapy group, patients were immersed in a hot spring at 40°C for 10min daily for two weeks; in the control group, patients took a daily shower. We measured plasma brain natriuretic peptide (BNP) and asymmetric dimethylarginine (ADMA). The left ventricular ejection fraction (LVEF) and cardiothoracic ratio (CTR) were evaluated by echocardiography and chest radiography, respectively. Brachial-ankle pulse-wave velocity (baPWV) was measured non-invasively using an automatic device.
Results: Clinical symptoms were improved after two weeks of hot spring therapy. Although heart rate and CTR did not change, clinical symptom and LVEF improved and mean blood pressure, BNP, ADMA and PWV significantly decreased.
Conclusions: Repeated immersion in a hot spring improves peripheral vascular endothelial function, thus leading to improvement of clinical activity and symptoms in patients with CHF.

Recently, air pollution by particlate matter (PM) including PM2.5 (less than 2.5 micron in diameter) and ultrafine particle (UFP: less than 0.1 micron in diameter) is raising important issue for cardiovascular and respiratory disease in Japan. In western Japan, Asian dust (yellow sand) flying in the early spring is affecting human daily life. Moreover, volcanic ashes also influence human activity that is living around the volcanic area. Increased PMs is known to be usually caused by industrial activities and/or natural disasters. Acute exposure has been linked to a range of adverse cardiovascular events, including hospital admissions with angina, myocardial infarction, and heart failure. Long-term exposure is thought to promote the atherosclerosis and impair cardiovascular risk factors. Recent experimental and epidemiologic studies show that PM2.5 is able to reach the small airways and terminal alveoli, and UFP can also be translocated directly into the systemic circulation, which lead to the releases of immunological, oxidative and inflammatory mediators, autonomic nervous system imbalance, and endothelia dysfunction resulting in impairment of cardiovascular risk factor and diseases. In this review, we would like to discuss the influence of PM2.5 on cardiovascular disease.