Beat-to-beat blood pressure and heart rate responses to the Valsalva maneuver

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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Abbreviations

AAG:

Autoimmune autonomic ganglionopathy

ANS:

Autonomic nervous system

COI:

Chronic orthostatic intolerance

NE:

Norepinephrine

MSA:

Multiple system atrophy

OH:

Orthostatic hypotension

OI:

Orthostatic intolerance

PAF:

Pure autonomic failure

PNS:

Parasympathetic nervous system

POTS:

Postural tachycardia syndrome

SAS:

Sympathetic adrenergic system

SCS:

Sympathetic cholinergic system

SEC:

Skin electrical conductance

SNS:

Sympathetic noradrenergic system

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Correspondence to David S. Goldstein.

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Funding

The research reported here was supported by the Division of Intramural Research, NINDS, NIH (grant no. 1ZIANS003034).

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Goldstein, D.S., Cheshire, W.P. Beat-to-beat blood pressure and heart rate responses to the Valsalva maneuver. Clin Auton Res 27, 361–367 (2017). https://doi.org/10.1007/s10286-017-0474-y

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Keywords

  • Autonomic
  • Sympathetic
  • Parasympathetic
  • Valsalva
  • Blood pressure