Beat-to-beat blood pressure and heart rate responses to the Valsalva maneuver |
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Authors: | David S Goldstein Jr" target="_blank">William P CheshireJr |
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Institution: | 1.Clinical Neurocardiology Section, Clinical Neurosciences Program, Division of Intramural Research, National Institute of Neurological Disorders and Stroke,National Institutes of Health,Bethesda,USA;2.Department of Neurology,Mayo Clinic,Jacksonville,USA |
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Abstract: | Measurement of beat-to-beat blood pressure and heart rate responses to the Valsalva maneuver is the basis for a highly informative autonomic function test. Whereas in the past this measurement required intra-arterial cannulation, the development of finger cuff devices that acquire arterial pressure waveforms indistinguishable from those recorded intra-arterially has made it possible to obtain accurate measurements noninvasively. In a patient with orthostatic hypotension, the pattern of blood pressure responses during and after the release of the maneuver can identify a neurogenic basis: sympathetic neurocirculatory failure. The quantifiable change in cardiac interbeat interval per unit change in systolic pressure during the maneuver can identify baroreflex-cardiovagal failure. |
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