Key result
The bedside Valsalva maneuver provided a semiquantitative estimate of resting left ventricular systolic function (P<0.02), and the SQW response pattern was highly predictive of sudden cardiac death.
Why the study?
Does the bedside Valsalva maneuver predict sudden cardiac death and estimate left ventricular systolic function in survivors of first myocardial infarction?
Cohort (n=100)
Does the bedside Valsalva maneuver predict sudden cardiac death and estimate left ventricular systolic function in survivors of first myocardial infarction?
p-value: p=<0.02
The bedside Valsalva maneuver is a simple, safe, and inexpensive method for risk stratification and predicting sudden cardiac death in post-myocardial infarction patients.
May aid post-MI SCD risk stratification; leaves open prospective validation before clinical adoption.
One hundred survivors of first myocardial infarction were studied prior to hospital discharge by 24 hour ambulatory electrocardiography as well as radionuclide ventriculography. The bedside Valsalva maneuver, with simple sphygmomanometric determination of arterial pressure response, was performed 6 weeks post infarction and patients were followed for a mean of 22 months. The arterial pressure response pattern provided a semiquantitative estimate of resting left ventricular systolic function when related to the radionuclide ejection fraction (SIN, 0.56 +/- 0.13; ABO, 0.43 +/- 0.18; SQW, 0.16 +/- 0.06) (P less than 0.02). Abnormal Valsalva responses (ABO and SQW) were found more commonly in patients with diminished left ventricular systolic function and high grade ventricular arrhythmias. The SQW response pattern was highly predictive of future sudden cardiac death. The bedside Valsalva maneuver, performed 2-4 weeks after hospital discharge, upon the ambulatory patient is a simple, safe, inexpensive and uniformly applicable method which may serve as the basis for a strategy with which to approach the post-infarction patient regarding risk stratification and further clinical management.
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Michael J. Zema (1985) conducted a cohort in First myocardial infarction (n=100). Bedside Valsalva maneuver was evaluated on Resting left ventricular systolic function (radionuclide ejection fraction) (p=<0.02). The bedside Valsalva maneuver provided a semiquantitative estimate of resting left ventricular systolic function (P<0.02), and the SQW response pattern was highly predictive of sudden cardiac death.
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