@article { , title = {Is swimming safe in heart failure? : a systematic review}, 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.}, doi = {10.1097/CRD.0000000000000154}, eissn = {1538-4683}, issn = {1061-5377}, issue = {6}, journal = {Cardiology review}, pages = {321-325}, publicationstatus = {Published}, publisher = {Lippincott, Williams \& Wilkins}, url = {https://hull-repository.worktribe.com/output/456439}, volume = {25}, keyword = {Health and Health Inequalities, Heart failure, Water immersion, Swimming}, year = {2017}, author = {Shah, Parin M. and Pellicori, Pierpaolo and Macnamara, Alexandra and Urbinati, Alessia and Clark, Andrew L.} }