A controlled clinical trial of leg thermal therapy in conjunction with standard cardiac rehabilitation in patients with decompensated heart failure

[Purpose] Leg thermal therapy (LTT) using far-infrared-ray dry sauna stimulation improves hemodynamics in patients with heart failure (HF); however, its additive effect when combined with cardiac rehabilitation (CR) remains unknown. This study aimed to investigate whether incorporating LTT into acute-phase CR confers exercise capacity in hospitalized patients with HF. [Participants and Methods] Seventeen patients with decompensated HF (median age 75 years) admitted between June 2018 and November 2019 were prospectively assigned to the CR plus LTT (11 participants) or the CR group (6 participants). Both groups performed structured exercise sessions for 40 min, five times a week. The LTT group received additional leg heating at 45°C for 20 min. Cardiopulmonary function and blood tests were performed before and after the intervention. [Results] At one month, peak oxygen uptake was equal between groups. However, anaerobic threshold oxygen uptake increased in the CR plus LTT group, noradrenaline levels decreased, and no complications were observed. [Conclusion] The addition of LTT to CR did not improve overall exercise capacity in hospitalized patients with HF, but it contributes to specific physiological improvements. Hence, this could be a potential approach to optimize cardiac rehabilitation for patients with decompensated HF.