Valsalva maneuver: shortest optimal expiratory strain duration
Purpose : To quantitate the level of difficulty and determine consistency of hemodynamic responses with various expiratory strain (ES) durations. Methods : Thirty-four healthy subjects performed the Valsalva maneuver (VM) with an ES duration of 10, 12, and 15 seconds in random order. Level of diffic...
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| Format: | Article |
| Language: | English |
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Greater Baltimore Medical Center
2011-07-01
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| Series: | Journal of Community Hospital Internal Medicine Perspectives |
| Subjects: | |
| Online Access: | http://www.jchimp.net/index.php/jchimp/article/view/7015/pdf_195 |
| _version_ | 1797968103089373184 |
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| author | Ramesh K. Khurana, Md Deepika Mittal, Md Norman H. Dubin, Ph.D. |
| author_facet | Ramesh K. Khurana, Md Deepika Mittal, Md Norman H. Dubin, Ph.D. |
| author_sort | Ramesh K. Khurana, Md |
| collection | DOAJ |
| description | Purpose : To quantitate the level of difficulty and determine consistency of hemodynamic responses with various expiratory strain (ES) durations. Methods : Thirty-four healthy subjects performed the Valsalva maneuver (VM) with an ES duration of 10, 12, and 15 seconds in random order. Level of difficulty after each trial was rated 1 to 10, with 10 being the most difficult. Blood pressure and heart rate (HR) were recorded continuously and non-invasively. Parameters studied were Valsalva ratio (VR), early phase II (IIE), late phase II (IIL), tachycardia latency (TL), bradycardia latency (BL), and overshoot latency (OV-L). Consistency of responses was calculated. Results : Difficulty increased significantly with increased ES duration: 5.1±0.1 (mean±SEM) at 10 seconds, 5.9±0.1 at 12 seconds, and 6.8±0.1 at 15 seconds (p<0.001). Phase IIE, TL, BL, OV-L, and VR response did not differ statistically with increasing ES durations, and there were no differences in variability. Phase IIL response increased significantly with increasing ES duration. Phase IIL was poorly delineated in 14 of 102 trials with 10 seconds ES duration. Conclusions : ES duration of 10 seconds created a low level of difficulty in healthy individuals. This strain duration produced consistent hemodynamic response for all parameters tested except IIL phase. The absence of IIL phase with 10 seconds ES should not be interpreted as an indicator of sympathetic vasoconstrictor failure. |
| first_indexed | 2024-04-11T02:40:34Z |
| format | Article |
| id | doaj.art-e8117518863f44b1972adc853db4aba9 |
| institution | Directory Open Access Journal |
| issn | 2000-9666 |
| language | English |
| last_indexed | 2024-04-11T02:40:34Z |
| publishDate | 2011-07-01 |
| publisher | Greater Baltimore Medical Center |
| record_format | Article |
| series | Journal of Community Hospital Internal Medicine Perspectives |
| spelling | doaj.art-e8117518863f44b1972adc853db4aba92023-01-02T19:07:40ZengGreater Baltimore Medical CenterJournal of Community Hospital Internal Medicine Perspectives2000-96662011-07-01121510.3402/jchimp.v1i2.7015Valsalva maneuver: shortest optimal expiratory strain durationRamesh K. Khurana, MdDeepika Mittal, MdNorman H. Dubin, Ph.D.Purpose : To quantitate the level of difficulty and determine consistency of hemodynamic responses with various expiratory strain (ES) durations. Methods : Thirty-four healthy subjects performed the Valsalva maneuver (VM) with an ES duration of 10, 12, and 15 seconds in random order. Level of difficulty after each trial was rated 1 to 10, with 10 being the most difficult. Blood pressure and heart rate (HR) were recorded continuously and non-invasively. Parameters studied were Valsalva ratio (VR), early phase II (IIE), late phase II (IIL), tachycardia latency (TL), bradycardia latency (BL), and overshoot latency (OV-L). Consistency of responses was calculated. Results : Difficulty increased significantly with increased ES duration: 5.1±0.1 (mean±SEM) at 10 seconds, 5.9±0.1 at 12 seconds, and 6.8±0.1 at 15 seconds (p<0.001). Phase IIE, TL, BL, OV-L, and VR response did not differ statistically with increasing ES durations, and there were no differences in variability. Phase IIL response increased significantly with increasing ES duration. Phase IIL was poorly delineated in 14 of 102 trials with 10 seconds ES duration. Conclusions : ES duration of 10 seconds created a low level of difficulty in healthy individuals. This strain duration produced consistent hemodynamic response for all parameters tested except IIL phase. The absence of IIL phase with 10 seconds ES should not be interpreted as an indicator of sympathetic vasoconstrictor failure.http://www.jchimp.net/index.php/jchimp/article/view/7015/pdf_195Valsalva maneuverValsalva ratioexpiratory strainblood pressureheart rateclinical |
| spellingShingle | Ramesh K. Khurana, Md Deepika Mittal, Md Norman H. Dubin, Ph.D. Valsalva maneuver: shortest optimal expiratory strain duration Journal of Community Hospital Internal Medicine Perspectives Valsalva maneuver Valsalva ratio expiratory strain blood pressure heart rate clinical |
| title | Valsalva maneuver: shortest optimal expiratory strain duration |
| title_full | Valsalva maneuver: shortest optimal expiratory strain duration |
| title_fullStr | Valsalva maneuver: shortest optimal expiratory strain duration |
| title_full_unstemmed | Valsalva maneuver: shortest optimal expiratory strain duration |
| title_short | Valsalva maneuver: shortest optimal expiratory strain duration |
| title_sort | valsalva maneuver shortest optimal expiratory strain duration |
| topic | Valsalva maneuver Valsalva ratio expiratory strain blood pressure heart rate clinical |
| url | http://www.jchimp.net/index.php/jchimp/article/view/7015/pdf_195 |
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