Naslov
Balneotherapy in patients with compromised left ventricular function

Autori
Čerkez Habek, Jasna ; Šikić, Jozica ; Gulin, Dario

Izvornik
Cardiologia Croatica (1848-543X) 13 (2018), 11-12; 353-353

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, ostalo

Ključne riječi
left ventricle dysfunction, swimming, balneotherapy.

Sažetak
Aim: exploring literature on water immersion, balneo-therapy aqua exercise and swimming in patients with left ventricular dysfunction (LVD) and/or stable chronic heart failure (CHF). Aqua exercise is recommended for low-risk cardiac patients, but it is not clear whether it is safe, or what optimal water temperature in patients with CHF is. With water immersion, the water rises pressure on the body surface and blood volume shifts to the central cir-culation, resulting in marked volume loading of the heart, but only if immersion is up to the neck, with enlargement of all 4 chambers, in 6 seconds up to 30% increase in heart size.1Results: Until now, based on exploratory studies of central hemodynamics and neurohumoral responses of aquatic therapies it is clear that: 1) In patients with LVD a posi-tive effect of therapeutic warm-water tub bathing is due to afterload reduction caused by peripheral vasodilata-tion with warm water ; 2) In coronary patients with LVD, at low-level water cycling, the heart is working more ef-ficiently than at low-level cycling outside of water ; 3) In patients with previous extensive myocardial infarction, immersion to the neck resulted in temporary pathologi-cal increases in mean pulmonary artery pressure (mPAP) and mean pulmonary capillary pressures (mPCP) ; 4) Dur-ing slow swimming the mPAP and/or PCP were higher than during supine cycling outside water at a 100W load ; 5) In CHF patients, neck-deep immersion resulted in a de-crease or no change in stroke volume ; 6) Even hemody-namically compromised, patients feel well during aquatic therapy: 7) Decompensated heart failure is an absolute contraindication for immersion or swimming ; 8) Patient with severe LVD or CHF who can sleep in a flat position can bath in the tube, immersed no deeper up the xiphoid ; 9) Therapeutic water exercise in a pool can be allowed, provided that the patient is in an upright position im-mersed no deeper than up to xiphoid. Conclusion: Based on these findings, whether swimming is truly safe, yet needs to be proven for patients with severe LVD.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA