Water Immersion in Right-Sided Heart Failure: A Pilot Study

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.