For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
33
views
32
references
 Top references
cited by
5
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      328
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Benefit of warm water immersion on biventricular function in patients with chronic heart failure

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Regular physical activity and exercise are well-known cardiovascular protective factors. Many elderly patients with heart failure find it difficult to exercise on land, and hydrotherapy (training in warm water) could be a more appropriate form of exercise for such patients. However, concerns have been raised about its safety.

          The aim of this study was to investigate, with echocardiography and Doppler, the acute effect of warm water immersion (WWI) and effect of 8 weeks of hydrotherapy on biventricular function, volumes and systemic vascular resistance. A secondary aim was to observe the effect of hydrotherapy on brain natriuretic peptide (BNP).

          Methods

          Eighteen patients [age 69 ± 8 years, left ventricular ejection fraction 31 ± 9%, peakVO 2 14.6 ± 4.5 mL/kg/min] were examined with echocardiography on land and in warm water (34°C).

          Twelve of these patients completed 8 weeks of control period followed by 8 weeks of hydrotherapy twice weekly.

          Results

          During acute WWI, cardiac output increased from 3.1 ± 0.8 to 4.2 ± 0.9 L/min, LV tissue velocity time integral from 1.2 ± 0.4 to 1.7 ± 0.5 cm and right ventricular tissue velocity time integral from 1.6 ± 0.6 to 2.5 ± 0.8 cm (land vs WWI, p < 0.0001, respectively). Heart rate decreased from 73 ± 12 to 66 ± 11 bpm (p < 0.0001), mean arterial pressure from 92 ± 14 to 86 ± 16 mmHg (p < 0.01), and systemic vascular resistance from 31 ± 7 to 22 ± 5 resistant units (p < 0.0001).

          There was no change in the cardiovascular response or BNP after 8 weeks of hydrotherapy.

          Conclusion

          Hydrotherapy was well tolerated by all patients. The main observed cardiac effect during acute WWI was a reduction in heart rate, which, together with a decrease in afterload, resulted in increases in systolic and diastolic biventricular function. Although 8 weeks of hydrotherapy did not improve cardiac function, our data support the concept that exercise in warm water is an acceptable regime for patients with heart failure.

          Related collections

          Most cited references32

          • Record: found
          • Abstract: found
          • Article: not found

          Randomized, controlled trial of long-term moderate exercise training in chronic heart failure: effects on functional capacity, quality of life, and clinical outcome.

          Romualdo Belardinelli, Demetrios Georgiou, Giovanni Cianci … (1999)
          It is still a matter of debate whether exercise training (ET) is a beneficial treatment in chronic heart failure (CHF). To determine whether long-term moderate ET improves functional capacity and quality of life in patients with CHF and whether these effects translate into a favorable outcome, 110 patients with stable CHF were initially recruited, and 99 (59+/-14 years of age; 88 men and 11 women) were randomized into 2 groups. One group (group T, n=50) underwent ET at 60% of peak &f1;O2, initially 3 times a week for 8 weeks, then twice a week for 1 year. Another group (group NT, n=49) did not exercise. At baseline and at months 2 and 14, all patients underwent a cardiopulmonary exercise test, while 74 patients (37 in group T and 37 in group NT) with ischemic heart disease underwent myocardial scintigraphy. Quality of life was assessed by questionnaire. Ninety-four patients completed the protocol (48 in group T and 46 in group NT). Changes were observed only in patients in group T. Both peak &f1;O2 and thallium activity score improved at 2 months (18% and 24%, respectively; P<0. 001 for both) and did not change further after 1 year. Quality of life also improved and paralleled peak VO2. Exercise training was associated both with lower mortality (n=9 versus n=20 for those with training versus those without; relative risk (RR)=0.37; 95% CI, 0.17 to 0.84; P=0.01) and hospital readmission for heart failure (5 versus 14; RR=0.29; 95% CI, 0.11 to 0.88; P=0.02). Independent predictors of events were ventilatory threshold at baseline (beta-coefficient=0.378) and posttraining thallium activity score (beta-coefficient -0.165). Long-term moderate ET determines a sustained improvement in functional capacity and quality of life in patients with CHF. This benefit seems to translate into a favorable outcome.
          Article 0 comments Cited 105 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Effects of exercise training on cardiac performance, exercise capacity and quality of life in patients with heart failure: a meta-analysis.

            Cornelis J. J. Huijsmans, W Kroon, Maaike Schothorst … (2006)
            Despite major advances in pharmacological treatment of chronic heart failure (CHF), a number of patients still suffer from dyspnoea, fatigue, diminished exercise capacity and poor quality of life. It is in this context that exercise training is being intensively evaluated for any additional benefit in the treatment of CHF. To determine the effect of exercise training in patients with CHF on cardiac performance, exercise capacity and health-related quality of life. A meta-analysis was performed to obtain this goal. After including 35 randomised controlled trials, the methodological quality of each study was assessed, summary effect sizes (SESs) and the concomitant 95% confidence intervals (95% CI) were calculated for each outcome. Quantitative analysis showed statistically significant SESs, at rest, for diastolic blood pressure and end-diastolic volume. During maximal exercise, significant SESs were found for systolic blood pressure, heart rate, cardiac output, peak oxygen uptake, anaerobic threshold and 6-min walking test. The Minnesota Living with Heart Failure Questionnaire improved by an average of 9.7 points. Exercise training has clinically important effects on exercise capacity and HRQL, and may have small positive effects on cardiac performance during exercise.
            Article 0 comments Cited 54 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Acute hemodynamic improvement by thermal vasodilation in congestive heart failure.

              Chuwa Tei, Yutaka Horikiri, Jong-Chun Park … (1995)
              A warm-water bath (WWB) or sauna bath (SB) has generally been considered inappropriate for patients with severe congestive heart failure (CHF). However, a comprehensive investigation of the hemodynamic effects of thermal vasodilation in CHF has not been previously undertaken. To investigate the acute hemodynamic effects of thermal vasodilation in CHF, we studied 34 patients with chronic CHF (mean age, 58 +/- 14 years). Clinical stages were New York Heart Association functional class II in 2, III in 19, and IV in 13 patients. Mean ejection fraction was 25 +/- 9%. After a Swan-Ganz catheter was inserted via the right jugular vein, the patient had a WWB for 10 minutes at 41 degrees C or an SB for 15 minutes at 60 degrees C. Blood pressure, ECG, echo-Doppler, expiration gas, and intracardiac pressures were recorded before, during, and 30 minutes after each bath. Oxygen consumption increased mildly, pulmonary arterial blood temperature increased by 1.2 degrees C, and heart rate increased by 20 to 25 beats per minute on average at the end of WWB or SB. Systolic blood pressure showed no significant change. Diastolic blood pressure decreased significantly during SB (P < .01). Cardiac and stroke indexes increased and systemic vascular resistances decreased significantly during and after WWB and SB (P < .01). Mean pulmonary artery, mean pulmonary capillary wedge, and mean right atrial pressures increased significantly during WWB (P < .05) but decreased significantly during SB (P < .05). These pressures decreased significantly from the control level after each bath (P < .01). Mitral regurgitation associated with CHF decreased during and 30 minutes after each bath. Cardiac dimensions decreased and left ventricular ejection fraction increased significantly after WWB and SB. In an additional study, plasma norepinephrine increased significantly during SB in healthy control subjects and in patients with CHF and returned to control levels by 30 minutes after SB. Hemodynamics improve after WWB or SB in patients with chronic CHF. This is attributable to the reduction in cardiac preload and afterload. Thus, thermal vasodilation can be applied with little risk if appropriately performed and may provide a new nonpharmacological therapy for CHF.
              Article 0 comments Cited 49 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): Cardiovasc Ultrasound
                Title: Cardiovascular Ultrasound
                Publisher: BioMed Central
                ISSN (Electronic): 1476-7120
                Publication date Collection: 2009
                Publication date (Electronic): 6 July 2009
                Volume: 7
                Page: 33
                Affiliations
                [1 ]Department of Molecular and Clinical Medicine/Cardiology, Wallenberg Laboratory, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Sweden
                [2 ]Institute of Neuroscience and Physiotherapy, Sahlgrenska Academy at the University of Gothenburg, Sweden
                Article
                Publisher ID: 1476-7120-7-33
                DOI: 10.1186/1476-7120-7-33
                PMC ID: 2713206
                PubMed ID: 19580653
                SO-VID: 527fbbef-4898-4279-a662-69b38c616c5f
                Copyright © Copyright © 2009 Grüner Sveälv et al; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 25 May 2009
                Date accepted : 6 July 2009
                Categories
                Subject: Research

                ScienceOpen disciplines: Cardiovascular Medicine
                Data availability:
                ScienceOpen disciplines: Cardiovascular Medicine

                Comments

                Comment on this article

                scite_

                Similar content328

                See all similar

                Cited by5

                See all cited by

                Most referenced authors295

                See all reference authors