Thermal therapy: a viable adjunct in the treatment of heart failure?

The aim of this work was to review and provide a summary of published literature on the clinical impact of thermal therapy (ie, warm water immersion, traditional sauna bathing, and dry infrared sauna) in patients with heart failure. Medline and Embase database literature searches were conducted, and studies that included measurement of heart failure-related clinical parameters were reviewed. Thermal therapy was found to have a positive impact on key heart failure-related parameters across multiple studies. Significant improvements were noted across a wide scope of heart failure-related parameters in the areas of (1) endothelial function, (2) hemodynamics, (3) cardiac geometry, (4) neurohormonal markers, and (5) quality of life. Of special note, thermal therapy also conveyed a strong antiarrhythmic effect in heart failure patients. The clinical evidence highlights repeatable and compelling data showing that thermal therapy may provide an important and viable adjunct in the treatment of heart failure.

Nonbacterial thrombotic endocarditis presenting as aortic stenosis with suspected infective endocarditis: clinicopathological correlation.

Endocarditis has been traditionally classified as infective and non-bacterial thrombotic endocarditis (NBTE). NBTE has been associated with connective tissue diseases, chronic inflammatory processes and malignancy. During the pre-echocardiography era, the diagnosis of NBTE was most commonly determined at postmortem examination. A 63-year-old female patient with transient cerebral ischemic attacks and weight loss, who subsequently presented with aortic stenosis, is reported. She was treated for infective endocarditis, but developed a clinical picture of sepsis with disseminated intravascular coagulation. Despite aortic valve replacement, she died early postoperatively. Autopsy found valvular NBTE, multiple vascular thromboses and associated metastatic adenocarcinoma of unknown primary site. NBTE associated with malignancy April clinically mimic sepsis and infective endocarditis.

Phosphatidylinositol increases HDL-C levels in humans.

Studies have shown that phosphatidylinositol (PI) can stimulate reverse cholesterol transport by enhancing the flux of cholesterol into HDL and by promoting the transport of high density lipoprotein-cholesterol (HDL-C) to the liver and bile. The goal of this study was to determine the safety and therapeutic value of PI after oral administration to normolipidemic human subjects. We performed a randomized 2 week study in 16 normolipidemic subjects. Subjects received either 2.8 or 5.6 g of PI, with or without food. PI was well tolerated by all subjects. PI significantly affected the levels of HDL-C and triglyceride in the plasma of subjects receiving PI with food. The lower dose showed a 13% increase in HDL-C, whereas the high dose showed an increase of 18% over the 2 week period. Both low- and high-dose groups showed significant increases in plasma apolipoprotein A-I. The high dose of PI also decreased plasma triglycerides by 36% in the fed subjects. These data suggest that after only 2 weeks, PI may have a comparable therapeutic value to niacin, with negligible side effects.