PMID- 8237763
OWN - NLM
STAT- MEDLINE
DCOM- 19931129
LR  - 20190626
IS  - 0002-8703 (Print)
IS  - 0002-8703 (Linking)
VI  - 126
IP  - 5
DP  - 1993 Nov
TI  - Abnormal Valsalva blood pressure response in dilated cardiomyopathy: association 
      with "pseudonormalization" of echocardiographic Doppler transmitral filling 
      velocity pattern.
PG  - 1182-6
AB  - In patients with dilated cardiomyopathies, the presence of an abnormal blood 
      pressure response to the Valsalva maneuver has been shown to correlate well with 
      increased left-sided filling pressures. The presence of a "pseudonormalized" 
      early peak to late peak velocity (E/A) ratio on echocardiographic Doppler 
      transmitral filling pattern has also been correlated with increased left 
      ventricular end-diastolic pressures in these patients. Since both abnormal blood 
      pressure response to the Valsalva maneuver and a "pseudonormalized" Doppler 
      transmitral E/A ratio probably represent elevated left ventricular filling 
      pressure, we postulated that there would be a positive correlation between the 
      two in a group of patients with dilated cardiomyopathy and abnormal systolic 
      function. Twenty-five consecutive male patients with New York Heart Association 
      (NYHA) class II to IV heart failure and dilated cardiomyopathy were included. 
      Patients with abnormal blood pressure responses to Valsalva had significantly 
      larger peak early (E) velocities, smaller peak late (A) velocities, and larger 
      E/A ratios compared with patients with normal responses. E/A ratio < 1.0 was 
      present in eight (100%) of the eight patients with a normal blood pressure 
      response to the Valsalva maneuver and E/A ratio > 1.0 was present in 12 (71%) of 
      17 patients with an abnormal response (p < 0.01). This correlation supports the 
      hypotheses of the physiologic mechanisms of these phenomena and also provides two 
      noninvasive methods of evaluating left-sided filling pressures useful in the 
      diagnosis and treatment of congestive heart failure caused by dilated 
      cardiomyopathy.
FAU - Schwengel, R H
AU  - Schwengel RH
AD  - University of Maryland School of Medicine, Baltimore 21201.
FAU - Hawke, M W
AU  - Hawke MW
FAU - Fisher, M L
AU  - Fisher ML
FAU - Gottlieb, S S
AU  - Gottlieb SS
FAU - Plotnick, G D
AU  - Plotnick GD
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
SB  - IM
MH  - Adult
MH  - Aged
MH  - Blood Flow Velocity
MH  - *Blood Pressure
MH  - Cardiac Volume
MH  - Cardiomyopathy, Dilated/diagnostic imaging/*physiopathology
MH  - Echocardiography, Doppler
MH  - Heart Ventricles/diagnostic imaging/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve/diagnostic imaging/*physiopathology
MH  - Stroke Volume
MH  - *Valsalva Maneuver
EDAT- 1993/11/01 00:00
MHDA- 1993/11/01 00:01
CRDT- 1993/11/01 00:00
PHST- 1993/11/01 00:00 [pubmed]
PHST- 1993/11/01 00:01 [medline]
PHST- 1993/11/01 00:00 [entrez]
AID - 0002-8703(93)90672-V [pii]
AID - 10.1016/0002-8703(93)90672-v [doi]
PST - ppublish
SO  - Am Heart J. 1993 Nov;126(5):1182-6. doi: 10.1016/0002-8703(93)90672-v.