The Valsalva maneuver: A bedside "biomarker" for heart failure

被引:56
作者
Felker, GM
Cuculich, PS
Gheorghiade, M
机构
[1] Duke Clin Res Inst, Durham, NC 27715 USA
[2] Northwestern Univ, Chicago, IL 60611 USA
关键词
heart failure; diagnosis; physical examination; Valsalva maneuver;
D O I
10.1016/j.amjmed.2005.06.059
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Accurate assessment of volume status remains an important clinical goal in the management of patients with heart failure. Although physical examination can provide clues to volume status, its sensitivity and reproducibility are limited. Other noninvasive methods, such as measurement of natriuretic peptides or the use of impedance cardiography, are not well validated. The cardiovascular response to the Valsalva maneuver had been proposed as a simple, inexpensive bedside test for estimating filling pressures in patients with heart failure. Our objective was to summarize and critically evaluate the evidence for the use of the Valsalva maneuver in evaluating volume status in patients with heart failure. Studies have demonstrated a significant correlation between the cardiovascular response to the Valsalva maneuver and invasively measured ventricular filling pressures in patients with clinical heart failure. Although often overlooked in clinical training and practice, the cardiovascular response to the Valsalva maneuver is a potentially useful, noninvasive means of evaluating filling pressures in patients with heart failure. (c) 2006 Elsevier Inc. All rights reserved.
引用
收藏
页码:117 / 122
页数:6
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