Water Immersion in Chronic Stable Heart Failure

Study Overview
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Brief Summary
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This study aims to investigate the effects of water immersion and exercise on heart function and blood flow in patients with chronic stable heart failure.

Official Title
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Water Immersion and Water-based Exercise in Patients With Chronic Stable Heart Failure: A Pilot Study

Conditions
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Heart Failure

Intervention / Treatment
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* Other: water immersion


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age >18 Established diagnosis of heart failure with NTpro BNP >100 Exclusion Criteria: Uncontrolled or severe heart failure, defined by NYHA class IV symptoms (breathlessness at rest) Severe fluid overload characterised as more than minimal pitting oedema of the ankles only Presence of haemodynamically significant valvular heart disease in the opinion of the investigator Haemoglobin <125 g/L Weight >120 kilograms Requiring long term oxygen supplementation in the community Hospitalisation for any cause within the last 6 weeks, that in the opinion of the investigator would affect the patients wellbeing in this study Unstable or severe stable angina that requires three or more antianginals Patients known to have disease causing immunocompromise such as HIV infection or undergoing chemotherapy Patients with active infection Dialysis patients Uncontrolled seizures; patients in whom the pool environment may trigger seizures, new diagnosis of epilepsy Insulin treated diabetic patients with hypoglycaemic episodes in the last 3 months. Pregnant women Central venous lines which are not tunnelled and are exposed superficially. Open access ports to lungs including tracheotomy sites Ventilation tubes for ears Nasogastric or gastrostomy tube in situ Presence of colostomy, ileostomy or urostomy. Presence of open, macerated, infected or non-intact skin or oedema with leakage of serous fluid. Skin condition such as severe eczema or psoriasis Any surgery or invasive devices fitted within the last 4 weeks Any form of mobility impairment requiring mobility aids (e.g. stick or wheelchair) or rendering patient unable to perform gentle exercises, including recent injury or trauma History of chlorine sensitivity Urinary or faecal incontinence Hydrophobia Unable to give consent
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: water immersion<br>patients with heart failure will be immersed to the neck for 15 minutes | Other: water immersion<br>* warm water immersion<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cardiac output |  | 15 minutes of water immersion | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Heart rate (beats/minute) |  | 15 minutes of water immersion | 
| Blood pressure (mmHg) |  | 15 minutes of water immersion | 
| systemic vascular resistance (dyn·s/cm5) |  | 15 minutes of water immersion | 
| Stroke volume (millilitres) |  | 15 minutes of water immersion | 
| Jugular venous pressure (not raised, raised 1-4cm, raised to earlobes, undetectable) |  | 15 minutes of water immersion | 
| BORG dyspnoea score (score between 1-10) |  | 15 minutes of water immersion | 
| cardiac output (milliliters/minute) |  | 3 minutes of exercise in water | 
| N-terminal pro b-type natriuretic peptide (ng/L) |  | 10 mins after water immersion | 
| Left ventricular end systolic diameter (mm) |  | 15 minutes of water immersion | 
| Left ventricular end diastolic diameters (mm) |  | 15 minutes of water immersion |