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(Circulation. 1968;38:277.)
© 1968 American Heart Association, Inc.

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Pressure Flow Studies in Patients Having a Pressor Response to the Valsalva Maneuver

JEROME RUSKIN M.D.¹; ALEXANDER HARLEY M.B., M.R.C.P.¹; JOSEPH C. GREENFIELD JR. M.D.¹

¹ From the Department of Medicine (Division of Cardiology), Duke University Medical Center and the Veterans Administration Hospital, Durham, North Carolina.

Blood pressure and flow were measured in the ascending aorta by means of the pressure-gradient technique in five patients with congestive heart failure manifesting a pressor response to the Valsalva maneuver. Beat-to-beat changes in stroke volume, blood pressure, pulse pressure, peak blood flow, duration of systole, duration of ejection, and heart rate were calculated. Stroke volume and blood pressure rose with the onset of straining; blood pressure rose slightly further as stroke volume fell to below control levels at the end of the straining period. Pulse pressure, peak blood flow, and duration of ejection tended to follow stroke volume. Heart rate was unchanged throughout. All parameters returned toward control after release of the strain.

Key Words: Pulsus alternans • Congestive heart failure • Filling pressure-cardiac output curve