Is swimming safe in heart failure? : a systematic review

Shah, Parin M.; Pellicori, Pierpaolo; Macnamara, Alexandra; Urbinati, Alessia; Clark, Andrew L.

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.

Citation

Shah, P. M., Pellicori, P., Macnamara, A., Urbinati, A., & Clark, A. L. (2017). Is swimming safe in heart failure? : a systematic review. Cardiology in review, 25(6), 321-325. https://doi.org/10.1097/CRD.0000000000000154

• Journal Article Type: Article
• Acceptance Date: Jun 22, 2017
• Online Publication Date: Nov 1, 2017
• Publication Date: 2017-11
• Deposit Date: Nov 10, 2017
• Publicly Available Date: Nov 5, 2018
• Journal: Cardiology review
• Print ISSN: 1061-5377
• Electronic ISSN: 1538-4683
• Publisher: Lippincott, Williams & Wilkins
• Peer Reviewed: Peer Reviewed
• Volume: 25
• Issue: 6
• Pages: 321-325
• DOI: https://doi.org/10.1097/CRD.0000000000000154
• Keywords: Heart failure; Water immersion; Swimming
• Public URL: https://hull-repository.worktribe.com/output/456439
• Publisher URL: https://journals.lww.com/cardiologyinreview/Abstract/2017/11000/Is_Swimming_Safe_in_Heart_Failure__A_Systematic.10.aspx
• Additional Information: This is the accepted manuscript of an article published in Cardiology in review, 2017. The version of record is available at the DOI link in this record.