Valsalva and modified valsalva maneuver

Mehmet Ali Kobat 1 * , Mehdi Karasu 2
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1 Cardiology Department, Firat University, Elazig, Turkey
2 Cardiology Department, Patnos State Hospital, Agri, Turkey
* Corresponding Author
J CLIN MED KAZ, Volume 3, Issue 57, pp. 6-10. https://doi.org/10.23950/1812-2892-JCMK-00770
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ABSTRACT

Valsalva maneuver is a diagnostic and adjunctive method in non-medical treatment of supraventricular tachycardia, in physical examination, differential diagnosis and imaging-guided evaluation of congenital heart defects and valvular diseases and also to show the presence of autonomic neuropathy caused by diabetes, chronic renal failure, certain cardiomyopathies and neurological disorders. The modified Valsalva maneuver is more effective and less complicated variant of the standard Valsalva maneuver.
Keywords: Valsalva, modified Valsalva, cardiovascular reflex

CITATION

Kobat MA, Karasu M. Valsalva and modified valsalva maneuver. Journal of Clinical Medicine of Kazakhstan. 2020;3(57):6-10. https://doi.org/10.23950/1812-2892-JCMK-00770

REFERENCES

  • Pstras L, Thomaseth K, Waniewski J, Balzani I, Bellavere F. The Valsalva manoeuvre: physiology and clinical examples. Acta Physiol (Oxf). 2016; 217(2):103-19. https://doi.org/10.1111/apha.12639
  • Aparci M, Guney Senol M, Yalcin M, Tansel Kendirli M, Isilak Z. Effective Valsalva maneuvering during TCCD and unrevealed etiology of RLS. Acta Neurol Scand. 2016; 133(4):313-4. https://doi.org/10.1111/ane.12485
  • Smith, G. Management of supraventricular tachycardia using the Valsalva manoeuvre: a historical review and summary of published evidence. Eur J Emerg Med. 2012. 19(6):346-52. https://doi.org/10.1097/MEJ.0b013e32834ec7ad
  • Junqueira LF Jr.Teaching cardiac autonomic function dynamics employing the Valsalva (Valsalva-Weber) maneuver. Adv Physiol Educ. 2008; 32(1):100-6. https://doi.org/10.1152/advan.00057.2007
  • Yang H, Carter JR. Baroreflex sensitivity analysis: spontaneous methodology vs. Valsalva's maneuver. Clin Auton Res. 2013; 23(3):133-9. https://doi.org/10.1007/s10286-013-0195-9
  • Davos CH, Davies LC, Piepoli M. The Effect of Baroreceptor Activity on Cardiovascular Regulation. Hellenic J Cardiol. 2002; 43:145-55.
  • Yamakawa K, So EL, Rajendran PS, et al. Electrophysiological effects of right and left vagal nerve stimulation on the ventricular myocardium. Am J Physiol Heart Circ Physiol. 2014; 307:H722. https://doi.org/10.1152/ajpheart.00279.2014
  • Yorgancıoğlu AC, Tokmakoğlu H. Cardiovascular Function and Physiology. In: Paç M, Akçevin A, Aka SA, Buket S, Sarıoğlu T editors. Cardiac surgery. 1st ed. MN Medikal and Nobel Ltd Şti. 2014; 21-32.
  • Svacinová J, Moudr J, Honzíková N. Baroreflex sensitivity: diagnostic importance, methods of determination and a model of baroreflex blood-pressure regulation. Cesk Fysiol. 2013; 62(1):10-8.
  • Cameron DA, Kirsh JA: Effect of posture, Valsalva maneuver and respiration on atrial flutter rate: an effect mediated through cardiac volume. J Am Coll Cardiol. 1991; 17:1545. https://doi.org/10.1016/0735-1097(91)90645-P
  • Lu ZY, Metzger BL, Therrien B: Ethnic differences in physiological responses associated with the Valsalva manuever. Res Nurs Health. 1990; 13:9. https://doi.org/10.1002/nur.4770130104
  • Shibasaki K, Ogawa S, Yamada S, Ouchi Y, Akishita M. Role of autonomic nervous activity, as measured by heart rate variability, on the effect of mortality in disabled older adults with low blood pressure in long-term care. Geriatr Gerontol Int. 2018. https://doi.org/10.1111/ggi.13328
  • Strobescu E, Graur M. The cardiovascular reflex tests in autonomic cardiac neuropathy diagnosis. Rev Med Chir Soc Med Nat Iasi. 2002; 106(4):746-52.
  • Hart EC, Charkoudian N. Sympathetic neural regulation of blood pressure: influences of sex and aging. Physiology (Bethesda). 2014; 29(1):8-15. https://doi.org/10.1152/physiol.00031.2013
  • Singer W, OpferGgehrking TL, McPhee BR, Hilz MJ, Low PA. Influence of posture on the Valsalva manoeuvre. Clin Sci (Lond). 2001; 100(4):433-40. https://doi.org/10.1042/cs1000433
  • Walker S, Cutting P. Impact of a modified Valsalva manoeuvre in the termination of paroxysmal supraventricular tachycardia. Emerg Med J. 2010; 27(4):287-91. https://doi.org/10.1136/emj.2009.073866
  • Sukla P, Shrivastava SR, Shrivastava PS, Rao NL. Assessment of the cardiac autonomic neuropathy among the known diabetics and age-matched controls using noninvasive cardiovascular reflex tests in a South-Indian population: A case-control study. Avicenna J Med. 2016; 6(3):81-5. https://doi.org/10.4103/2231-0770.184067
  • Vinik AI, Maser RE, Mitchell BD, Freeman R. Diabetic autonomic neuropathy. Diabetes Care. 2003; 26(5):1553-79. https://doi.org/10.2337/diacare.26.5.1553
  • Matta M, Pavy-Le Traon A, Perez-Lloret S, Laporte C, Berdugo I, Nasr N, Hanaire H, Senard JM. Predictors of Cardiovascular Autonomic Neuropathy Onset and Progression in a Cohort of Type 1 Diabetic Patients. J Diabetes Res. 2018; 2018:5601351. https://doi.org/10.1155/2018/5601351
  • Vinik AI, Erbas T, Casellini CM. Diabetic cardiac autonomic neuropathy, inflammation and cardiovascular disease. J Diabetes Investig. 2013; 4(1):4-18. https://doi.org/10.1111/jdi.12042
  • Jain S, Goldstein DS. Cardiovascular dysautonomia in Parkinson disease: from pathophysiology to pathogenesis. Neurobiol Dis. 2012; 46(3):572-80. https://doi.org/10.1016/j.nbd.2011.10.025
  • Shirbani F, Barin E, Lee YC, Ng K, Parratt JDE, Butlin M, Avolio AP. Characterisation of cardiac autonomic function in multiple sclerosis based on spontaneous changes of heart rate and blood pressure. Mult Scler Relat Disord. 2018;22:120-127. https://doi.org/10.1016/j.msard.2018.03.018 
  • Heart rate response to blood pressure variations: sympathetic activation versus baroreflex response in patients with end-stage renal disease. PLoS One. 2013; 8(10):e78338. https://doi.org/10.1371/journal.pone.0078338
  • Adams SC, Schondorf R, Benoit J, Kilgour RD. Impact of cancer and chemotherapy on autonomic nervous system function and cardiovascular reactivity in young adults with cancer: a case-controlled feasibility study. BMC Cancer. 2015;15:414. https://doi.org/10.1186/s12885-015-1418-3
  • Vasconcelos DF, Junqueira LF. Cardiac autonomic and ventricular mechanical functions in asymptomatic chronic chagasic cardiomyopathy. Jr.Arq Bras Cardiol. 2012; 98(2):111-9. https://doi.org/10.1590/S0066-782X2012005000002
  • Grimm RH Jr, Flack JM. Alpha 1 adrenoreceptor antagonists. J Clin Hypertens (Greenwich). 2011; 13(9):654-7. https://doi.org/10.1111/j.1751-7176.2011.00510.x
  • Head GA, Saigusa T, Mayorov DN.Braz. Angiotensin and baroreflex control of the circulation. J Med Biol Res. 2002; 35(9):1047-59. https://doi.org/10.1590/S0100-879X2002000900005
  • Sokolow M, Mcllroy MB, Cheitlin MD. Clinical Cardiology, Lebanon, Appleton and Lange. 1990; 624
  • Cheng TO.The proper conduct of Valsalva maneuver in the detection of patent foramen ovale. J Am Coll Cardiol. 2005; 45(7):1145-6. https://doi.org/10.1016/j.jacc.2004.12.054
  • Guigon-Souquet B, Salaun N, Macarez R, Bazin S, De La Marnierre E, Mazdou M. Subhyaloid hemorrhage following a Valsalva maneuver. J Fr Ophtalmol. 2004; 27(10):1159-62. https://doi.org/10.1016/S0181-5512(04)96288-2
  • Appelboam A, Reuben A, Mann C, Gagg J, Ewings P. Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial. Lancet. 2015. https://doi.org/10.1016/S0140-6736(15)61485-4
  • Çorbacıoğlu ŞK, Akıncı E, Çevik Y, Aytar H, Öncül MV, Akkan S, Uzunosmanoğlu H. Comparing the success rates of standard and modifiedValsalva maneuvers to terminate PSVT: A randomized controlled trial. Am J Emerg Med. 2017; 35(11):1662-1665. https://doi.org/10.1016/j.ajem.2017.05.034
  • Guo YZ, Gao YS, Guo ZN, Niu PP, Yang Y, Xing YQ. Comparison of Different Methods of Valsalva Maneuver for Right-to-left Shunt Detection by Contrast-Enhanced Transcranial Doppler. Ultrasound Med Biol. 2016; 42(5):1124-9. https://doi.org/10.1016/j.ultrasmedbio.2015.12.020
  • He L, Wang L, Li L, Liu X, Yu Y, Zeng X, Li H, Gu Y. A single-center randomized controlled trial observing the safety and efficacy of modified step-up graded Valsalva manoeuver in patients with vasovagal syncope. PLoS One. 2018;13(1):e0191880. https://doi.org/10.1371/journal.pone.0191880