Cited 2 times in
The Valsalva Maneuver Can Misdiagnose ‘Normal' as ‘Pseudonormal': A Word of Caution for an Echocardiographic Evaluation of Diastolic Function
DC Field | Value | Language |
---|---|---|
dc.contributor.author | 윤지현 | - |
dc.contributor.author | 임세중 | - |
dc.contributor.author | 최의영 | - |
dc.date.accessioned | 2015-01-06T16:51:33Z | - |
dc.date.available | 2015-01-06T16:51:33Z | - |
dc.date.issued | 2014 | - |
dc.identifier.issn | 0008-6312 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/98906 | - |
dc.description.abstract | Objectives: To identify differences in cardiac hemodynamic changes between the Valsalva maneuver and nitroglycerin (NTG) administration. Methods: Fifty-three subjects (37 men, 43 ± 12 years) with normal cardiac function [left ventricular ejection fraction ≥55%, early to late mitral inflow velocity ratio (E/A) ≥1, left atrial volume index ≤34 ml/m2 and early diastolic mitral annulus velocity (E') ≥8 cm/s] were enrolled. Doppler parameters were determined at rest, during the Valsalva maneuver and after NTG administration. Results: Decreased E, A and E/A were observed both during the Valsalva maneuver and after NTG administration (p < 0.0001 for all). However, the reduction in E (ΔEValsalva: -30 ± 16 cm/s vs. ΔENTG: -17 ± 17 cm/s) and E/A (ΔE/AValsalva: -0.37 ± 0.28 vs. ΔE/ANTG: -0.19 ± 0.25) and the prolongation of the deceleration time (DT) of E (ΔDTValsalva: 105 ± 74 ms vs. ΔDTNTG: 83 ± 63 ms) were more prominent during the Valsalva maneuver than with NTG administration (p < 0.0001 for all). Particularly, a greater decrease in E' was observed during the Valsalva maneuver (ΔE'Valsalva: -3 ± 2 cm/s vs. ΔE'NTG: -2 ± 2 cm/s, p < 0.0001). Eighteen subjects (34%) showed ΔE/A ≥0.5 during the Valsalva maneuver; thus, they were mislabeled as ‘pseudonormal', while only 3 subjects (6%) showed ΔE/A ≥0.5 after NTG administration. Conclusions: The Valsalva maneuver not only decreases preload but also affects myocardial performance, thus, its use can result in the mislabeling of normal subjects as pseudonormal. | - |
dc.description.statementOfResponsibility | open | - |
dc.format.extent | 355~362 | - |
dc.relation.isPartOf | CARDIOLOGY | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/2.0/kr/ | - |
dc.subject.MESH | Adult | - |
dc.subject.MESH | Diagnosis, Differential | - |
dc.subject.MESH | Diagnostic Errors* | - |
dc.subject.MESH | Diastole/physiology* | - |
dc.subject.MESH | Echocardiography, Doppler* | - |
dc.subject.MESH | Female | - |
dc.subject.MESH | Hemodynamics | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Male | - |
dc.subject.MESH | Middle Aged | - |
dc.subject.MESH | Stroke Volume | - |
dc.subject.MESH | Valsalva Maneuver* | - |
dc.title | The Valsalva Maneuver Can Misdiagnose ‘Normal' as ‘Pseudonormal': A Word of Caution for an Echocardiographic Evaluation of Diastolic Function | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학) | - |
dc.contributor.googleauthor | Moon J. | - |
dc.contributor.googleauthor | Yoon J.H. | - |
dc.contributor.googleauthor | Choi E.-Y. | - |
dc.contributor.googleauthor | Chung W.-J. | - |
dc.contributor.googleauthor | Kang W.C. | - |
dc.contributor.googleauthor | Rim S.-J. | - |
dc.identifier.doi | 10.1159/000358376 | - |
dc.admin.author | false | - |
dc.admin.mapping | false | - |
dc.contributor.localId | A02609 | - |
dc.contributor.localId | A03372 | - |
dc.contributor.localId | A04165 | - |
dc.relation.journalcode | J00457 | - |
dc.identifier.eissn | 1421-9751 | - |
dc.identifier.pmid | 24970614 | - |
dc.identifier.url | http://www.karger.com/Article/FullText/358376 | - |
dc.subject.keyword | Diastolic function | - |
dc.subject.keyword | Doppler imaging | - |
dc.subject.keyword | Echocardiography | - |
dc.subject.keyword | Nitroglycerine | - |
dc.subject.keyword | Valsalva maneuver | - |
dc.contributor.alternativeName | Yoon, Ji Hyun | - |
dc.contributor.alternativeName | Rim, Se Joong | - |
dc.contributor.alternativeName | Choi, Eui Young | - |
dc.contributor.affiliatedAuthor | Yoon, Ji Hyun | - |
dc.contributor.affiliatedAuthor | Rim, Se Joong | - |
dc.contributor.affiliatedAuthor | Choi, Eui Young | - |
dc.rights.accessRights | free | - |
dc.citation.volume | 128 | - |
dc.citation.number | 4 | - |
dc.citation.startPage | 355 | - |
dc.citation.endPage | 362 | - |
dc.identifier.bibliographicCitation | CARDIOLOGY, Vol.128(4) : 355-362, 2014 | - |
dc.identifier.rimsid | 53771 | - |
dc.type.rims | ART | - |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.