Non-invasive assessment of left ventricular response to Valsalva manoeuvre in normal and diabetic subjects using praecordial accelerocardiography
Hume, L.; Ewing, D.J.; Campbell, I.W.; Reuben, S.R.; Clarke, B.F.
British Heart Journal 41(2): 199-203
The left ventricular response to the Valsalva maneuver was studied in 5 normal subjects (group 1), 6 diabetics without autonomic neuropathy (group 2), and 5 diabetics with autonomic neuropathy (group 3), using the maximum amplitude of the precordial accelerocardiogram (DE) as a non-invasive index of left ventricular performance. During the Valsalva maneuver DE decreased in all 3 groups. In groups 1 and 2, DE increased significantly above the control value after release of the maneuver (DE overshoot) but this did not occur in group 3. Apparently the overshoot of DE in groups 1 and 2 reflects an increase in left ventricular contractility after release of the Valsalva maneuver and the absence of an overshoot in DE in the patients with autonomic neuropathy is the result of loss of cardiac adrenergic innervation. The ability to detect an abnormal cardiovascular response to the Valsalva maneuver using the non-invasive technique of precordial accelerocardiography may be of practical value in the assessment of left ventricular function.