Is swimming safe in heart failure? A systematic review

Shah, P., Pellicori, P. , Macnamara, A., Urbinati, A. and Clark, A. L. (2017) Is swimming safe in heart failure? A systematic review. Cardiology in Review, 25(6), pp. 321-325. (doi: 10.1097/CRD.0000000000000154) (PMID:28767502)

Abstract

It is not clear whether swimming is safe in patients with chronic heart failure. Ten studies examining the hemodynamic effects of acute water immersion (WI) (155 patients; average age 60 years; 86% male; mean left ventricular ejection fraction (LVEF) 29%) and 6 randomized controlled trials of rehabilitation comparing swimming with either medical treatment only (n = 3) or cycling (n = 1) or aerobic exercise (n = 2), (136 patients, average age 59 years; 84% male, mean LVEF 31%) were considered. In 7 studies of warm WI (30–35°C): heart rate (HR) fell (2% to −15%), and both cardiac output (CO) (7–37%) and stroke volume (SV) increased (13–41%). In 1 study of hot WI (41°C), systemic vascular resistance (SVR) fell (41%) and HR increased (33%). In 2 studies of cold WI (12–22°C), there were no consistent effects on HR and CO. Compared with medical management, swimming led to a greater increase in peak VO2 (7–14%) and 6 minute walk test (6MWT) (7–13%). Compared with cycle training, combined swimming and cycle training led to a greater reduction in resting HR (16%), a greater increase in resting SV (23%) and SVR (15%), but no changes in resting CO and a lesser increase in peak VO2 (6%). Compared with aerobic training, combined swimming and aerobic training lead to a reduction in resting HR (19%) and SVR (54%) and a greater increase in SV (34%), resting CO (28%), LVEF (9%), and 6MWT (70%). Although swimming appears to be safe, the studies conducted have been small, very heterogeneous, and inconclusive.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Pellicori, Dr Pierpaolo
• Authors: Shah, P., Pellicori, P., Macnamara, A., Urbinati, A., and Clark, A. L.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: Cardiology in Review
• Publisher: Lippincott, Williams & Wilkins
• ISSN: 1061-5377
• ISSN (Online): 1538-4683
• Copyright Holders: Copyright © 2017 Wolters Kluwer Health, Inc.
• First Published: First published in Cardiology in Review 25(6):321-325
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher