Water Immersion in Right-Sided Heart Failure: A Pilot Study
Water Immersion in Right-Sided Heart Failure: A Pilot Study
This is an unblinded pilot study comparing (against a randomized control day without water
 immersion) the diuretic and natriuretic effects of water immersion in patients with right
 heart failure.
Patients will be immersed in a tub for 3 hours (on one day) and neurohormones will be
 obtained before and after immersion. Urine will be collected for quantification and
 evaluation of sodium concentration.
Inclusion Criteria:

 -  Patients must have right sided failure secondary to right ventricular dysfunction,
 pulmonary hypertension, or tricuspid regurgitation

 -  Age greater than 18 years of age

 -  Right heart catheterization within the last year to rule out left-sided failure.

 -  Evidence of fluid overload as indicated by 2 or more of the following: 1.) 2+ or more
 pitting edema of the lower extremities, 2.) scrotal or penile edema, 3.) JVP greater
 than or equal to 10 cm, 4.) abdominal ascites

 Exclusion Criteria:

 -  Pulmonary capillary wedge pressure above 16 mmHg or history of elevated left
 ventricular filling pressures.

 -  Serum creatinine > 2.0

 -  Current use of an angiotensin I converting enzyme inhibitor or angiotensin receptor
 blocker will preclude participation in the RAS neurohormone portion of the study.