Background: The effects of immersion and training of patients with chronic heart failure (CHF) in warm water has not been thoroughly investigated. The aim of this study was to assess the acute hemodynamic response of immersion and peripheral muscle training in elderly patients with CHF. Methods: Thirteen CHF patients and 13 healthy subjects underwent echocardiography on land and in a temperature-controlled swimming pool (33 -34 -C). Results: Rest. Heart rate decreased (CHF, p = 0.01; control, p = 0.001) and stroke volume increased (CHF, p = 0.01; control, p = 0.001) during water immersion in both groups, with no change in systolic or diastolic blood pressure. Ejection fraction ( p < 0.05) and transmitral Doppler E / A ratio ( p = 0.01) increased in the CHF group, with no changes in left ventricular volumes. The healthy subjects had similar responses, but also displayed an increase in cardiac output ( p < 0.01) and left ventricular volumes ( p < 0.001). Exercise. Cardiac output and systolic blood pressure increased significantly in water, in both groups. Conclusion: A general increase in early diastolic filling was accompanied by a decrease in heart rate, leading to an increase in stroke volume and ejection fraction in most patients with CHF during warm water immersion. These beneficial hemodynamic effects might be the reason for the previously observed good tolerability of this exercise regime.

Patients with ankylosing spondylitis frequently have cardiac abnormalities, but they more often consist of disease-related aortic regurgitation or conduction system abnormalities than manifestations of atherosclerotic heart disease. Because aortic regurgitation or conduction abnormalities might cause insidious symptoms not easily interpreted as of cardiac origin, we suggest that both electrocardiography and echocardiography evaluation should be part of the routine management of patients with ankylosing spondylitis.

LV LAX systolic amplitude independently predicted survival, after adjustment for clinical variables and LV SAX function. These data further emphasise the importance of the basal parts of the ventricles for ventricular function and thereby long-term outcome.

The aim of this multicenter randomized controlled trial was to compare physiotherapist‐led exercise‐based cardiac rehabilitation (PT‐X) with physical activity on prescription (PAP) with regard to physical fitness, physical activity, health‐related quality of life (HR‐QoL), and metabolic risk markers in patients with permanent atrial fibrillation. Ninety six patients (28 women), age 74 (5) years, and ejection fraction ≥45% were randomized. An exercise tolerance test (primary outcome measure), muscle endurance tests, HR‐QoL, physical activity assessments (questionnaire and accelerometer), and blood sampling were performed. The PT‐X consisted of 60‐minute group sessions and home‐based exercise, both twice a week. The PAP consisted of 40 minutes of active walking, 4 times a week. Eighty seven patients completed the study. Exercise tolerance (maximum exercise capacity) improved significantly after PT‐X (n = 40) but not after PAP (n = 47) (16 vs −3 W; P < .0001). Muscle endurance also improved after PT‐X: shoulder flexion left arm (7 vs −1 repetition; P < .001), heel‐lift right leg (4 vs 1 repetition; P < .05), left leg (4 vs −1 repetition; P < .001), and shoulder abduction (17 vs −4 s; P < .010). PAP significantly increased energy expenditure. Health‐related quality of life and lab‐tests did not differ. PT‐X improved physical fitness in patients with permanent atrial fibrillation.

Functional age related changes in LV function are more prominent in the long axis, while differences between genders are more pronounced in short axis and in volume measurements. These findings might be of importance when remodelling processes are evaluated, as these appear to be different in men and women and also age related.