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
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.
- 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
- 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.