Changes in left ventricular volumes and cardiac output during the valsalva maneuver in normal subjects estimated by two dimensional echocardiography
Salih, M.M.; Komsouglu, B.; Davies, M.K.; Littler, W.A.
Journal of Cardiovascular Ultrasonography 6(3): 187-192
1987
Accession: 004908986
We used two-dimensional echocardiography to determine changes in end-systolic volume (ESV), end-diastolic volume (EDV), stroke volume (SV), ejection fraction (EF), and cardiac output (CO) during the phases of the Valsalva maneuver in eight normotensive male subjects. Control values (mean .+-. SD) were ESV 44 .+-. 6 ml, EDV 113 .+-. 9 ml, SV 68 .+-. 8 ml, EF 60 .+-. 8%, heart rate (HR) 66 .+-. 10/min, and CO 4.49 .+-. 0.7 L/min. These parameters were unchanged in phase I. In phase 2a significant reductions in mean ESV (29 .+-. 9%; p < 0.01), EDV (31 .+-. 5%; p < 0.01), SV (32.7 .+-. 10%; p < 0.01), and CO (28.8 .+-. 8%, p < 0.01) were observed with an increase in HR (12.5 .+-. 9%; p < 0.05). HR increased further in phase 2b but the other parameters were unchanged from phase 2a. Assessments was not possible in phase 3 because of respiratory movement. In phase 4, HR was significantly reduced (13.25 .+-. 8%; p < 0.05), while ESV, EDV, SV, and CO returned to control levels. EF was unchanged throughout. Two-dimensional echocardiography is a successful method for determining the rapid changes in LV volumes and CO. The changes in these parameters during the Valsalva maneuver are now delineated.