The Valsalva Maneuver: A Bedside “Biomarker” for Heart Failure - 18/08/11
, Phillip S. Cuculich, MD b, Mihai Gheorghiade, MD b
Requests for reprints should be addressed to Michael Felker, MD, MHS, Duke Clinical Research Institute, PO Box 17969, Durham, NC 27715.Abstract |
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.
Le texte complet de cet article est disponible en PDF.Keywords : Heart failure, Diagnosis, Physical examination, Valsalva maneuver
Plan
Vol 119 - N° 2
P. 117-122 - février 2006 Retour au numéro
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