Blood pressure recovery time following the Valsalva maneuver varied directly with the severity of adrenergic impairment and significantly correlated with previously utilized phases of the maneuver.
Observational
Does blood pressure recovery time (PRT) following the Valsalva maneuver correlate with the severity of adrenergic failure?
Blood pressure recovery time following the Valsalva maneuver is a valuable quantitative index of adrenergic failure, especially in severe cases where phase II_L cannot be recorded.
BACKGROUND: Blood pressure (BP) changes in response to the Valsalva maneuver (VM) reflect the integrity of the baroreflex that regulates BP, and the phases of VM are widely used indices of adrenergic evaluation. OBJECTIVE: To study the BP recovery time (PRT) following termination of VM back to baseline to determine if it could be an additional and better indicator of adrenergic function. METHODS: The authors evaluated three groups of patients with increasing degrees of adrenergic failure and an age-matched control group. Adrenergic failure was graded on the basis of systolic blood pressure (SBP) reduction to tilt: Group 1, orthostatic hypotension (OH; SBP > or = 30 mm Hg) ; Group 2, borderline OH (BOH; 30 > SBP > 10 mm Hg) ; and Group 3, sympathetic sudomotor failure. RESULTS: PRT was found to vary directly with severity of adrenergic impairment. PRT significantly correlated with previously utilized phases of the VM and baroreflex gain, with highest correlations with phases IIL (reflex vasoconstriction following initial fall in BP) and IV (BP overshoot following the VM). PRT extends the indices for the quantitation of adrenergic failure, since it will continue to parallel increasing adrenergic failure after phase IIL is lost and is a reliable index when IIL cannot be recorded. CONCLUSIONS: Pressure recovery time is a valuable index of adrenergic failure. It extends the value of the Valsalva maneuver by providing a quantitative index that is measurable in patients with severe adrenergic failure.
Vogel et al. (2005) conducted an observational in Autonomic failure. Valsalva maneuver (blood pressure recovery time) vs. Age-matched controls was evaluated on Correlation of blood pressure recovery time with severity of adrenergic impairment and previously utilized phases of the Valsalva maneuver. Blood pressure recovery time following the Valsalva maneuver varied directly with the severity of adrenergic impairment and significantly correlated with previously utilized phases of the maneuver.