Heart Failure
Conditions
Brief summary
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.
Interventions
OTHERwater immersion
warm water immersion
Sponsors
Hull University Teaching Hospitals NHS Trust
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Masking description
open label
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
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
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Cardiac output | 15 minutes of water immersion |
Secondary
| Measure | Time frame |
|---|---|
| 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 |
| Heart rate (beats/minute) | 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 |
| BORG dyspnoea score (score between 1-10) | 15 minutes of water immersion |
Countries
United Kingdom
Outcome results
None listed