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Am J Med Sci. 2013 Sep;346(3):187-9. doi: 10.1097/MAJ.0b013e31826af7de.

The mechanics of left ventricular filling during the strain phase of the valsalva maneuver in healthy subjects.

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1
Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.

Abstract

BACKGROUND:

The aim of this study was to investigate the mechanical changes in left ventricular filling during the strain phase of the Valsalva maneuver in healthy subjects.

METHODS:

Thirty healthy volunteers were recruited to undertake the Valsalva maneuver at a load of 40 mm Hg for 10 seconds. Parameters of left ventricle filling were determined by echocardiography at baseline and at the first and second beats during the strain phase.

RESULTS:

Compared with baseline values, the E, E/A ratio, E/esep ratio and E/elat ratio parameters all increased at the first beat (P < 0.05). Compared with the first beat values, the E, E/A ratio, E/esep ratio and E/elat ratio parameters all decreased at the second beat (P < 0.05). The results demonstrate that left ventricular filling decreases at the second beat during the strain phase of the Valsalva maneuver. Positive intrathoracic pressure decreases left-side heart and pulmonary vessel transmural pressure while increasing blood vessel resistance, which explains the decrease in left ventricular filling.

CONCLUSIONS:

The results provide a new understanding of the underlying mechanical mechanism of the Valsalva maneuver, indicating that it should be performed clinically at a lower load and shorter strain time to avoid adverse events.

PMID:
23114199
DOI:
10.1097/MAJ.0b013e31826af7de
[Indexed for MEDLINE]
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