Summary
A standardized Valsalva manoeuvre (VM) with a 15-s straining period was repeated in each of four postures by six male subjects. The postures were supine (SUP), sitting leaning back (LB), sitting leaning forward (LF) and standing (ST). During straining, the increase in heart rate (f c) was different between LB and LF (+50% and +23%, respectively P<0.05). The decrease in stroke volume (SV), which was monitored by means of impedance cardiography, was different (63%, 68%, 39%, and 72%, P<0.001) as well as the decrease in cardiac output (CO) (55%, 53%, 26%, and 61%, P<0.001) in SUP, LB, LF, and ST, respectively. Accordingly, after pressure release the smallest changes of SV, f c and CO were found in LF. In conclusion, cardiovascular stability during straining was increased during LF. Consequently, this posture would appear to be superior to other postures during unavoidable VM (weight lifting and defaecation). To perform tests on autonomic function LB would appear to be superior to the other postures because of the large autonomic responses, combined with minimum risk for the subject. The impedance method provided simple and reproducible determinations of SV changes during VM.
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References
Brooker JZ, Alderman EL, Harris DC (1974) Alterations in left ventricular volumes induced by Valsalva manoeuvre. Br Heart J 36: 713–718
Delius W, Hagbarth K-E, Hongell A, Wallin BG (1972) Manoeuvres affecting sympathetic outflow in human muscle nerves. Acta Physiol Scand 84: 82–94
Eckberg DL (1980) Parasympathetic cardiovascular control in human disease: a critical review of methods and results. Am J Physiol 239: H581-H593
Epstein SE, Beiser GD, Stampfer M, Braunwald E (1968) Role of the venous system in baroreceptor-mediated reflexes in man. J Clin Invest 47: 139–152
Fox IE, Crowley WP Jr, Grace JB, Wood EH (1966) Effects of the Valsalva maneuver on blood flow in the thoracic aorta in man. J Appl Physiol 21: 1553–1560
Gauer OH, Thron HL (1965) Postural changes in the circulation. In: Hamilton WF (ed) Handbook of Physiology. Circulation sect 2, vol. 3, chapt. 67. Am Physiol Society, Washington DC, pp 2409–2439
Greenfield JC, Cox RL, Hernandez RR, Thomas C, Schoonmaker FW (1967) Pressure-flow studies in man during the Valsalva maneuver with observations on the mechanical properties of the ascending aorta. Circulation 35: 653–661
Hamilton WF, Woodbury RA, Harper HT (1936) Physiological relationships between intrathoracic, intraspinal and arterial pressures. J Am Med Assoc 107: 853–856
Hessemer V, Brück K (1985) Influence of menstrual cycle on shivering, skin blood flow, and sweating responses measured at night. J Appl Physiol 59: 1902–1910
Korner PI, Tonkin AM, Uther JB (1976) Reflex and mechanical circulatory effects of graded Valsalva maneuvers in normal man. J Appl Physiol 40: 434–440
Kubicek WG, Karnegis JN, Patterson RP, Witsoe DA, Mattson RH (1966) Development and evaluation of an impedance cardiac output system. Aerosp Med 37: 1208–1212
Kubicek WG, Kottke FJ, Ramos MU, Patterson RP, Witsoe DA, Labree JW, Remole W, Layman TE, Schoening H, Gramela JT (1974) The Minnesota impedance cardiograph-theory and applications. Biomed Eng 9: 410–416
Olschewski H, Brück K (1988) Thermoregulatory, cardiovascular, and muscular factors related to exercise after precooling. J Appl Physiol 64: 803–811
Parisi AF, Harrington J, Askenazi J, Pratt RC, McIntyre KM (1976) Echocardiographic evaluation of the Valsalva maneuver in patients with and without heart failure. Circulation 54: 921–927
Rowell LB (1983) Cardiovascular adjustments to thermal stress. In: Shepherd JT, Abboud FM (eds) Handbook of Physiology. The cardiovascular system III, part 2. American Physiological Society, Bethesda, pp 967–1023
Ruskin J, Harley A, Greenfield JC Jr (1968) Pressure flow studies in patients having a pressor response to the Valsalva maneuver. Circulation 38: 277–281
Samueloff SL, Browse NL, Shepherd JT (1966) Response of the capacity vessels in human limbs to head-up tilt and suction on lower body. J Appl Physiol 21: 47–54
Strian F (1986) Autonome und sensomotorische Diabetesneuropathie. In: Strian F, Haslbeck M (eds) Autonome Neuropathie bei Diabetes Mellitus. Springer, Berlin Heidelberg New York Tokyo, pp 3–85
Sundlöf G, Wallin BG (1978) Effect of lower body negative pressure on human muscle nerve sympathetic activity. J Physiol 278: 525–532
Tripathi A, Shi X, Wenger CB, Nadel ER (1984) Effect of temperature and baroreceptor stimulation on reflex venomotor responses. J Appl Physiol 57: 1384–1392
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Olschewski, H., Brück, K. Cardiac responses to the Valsalva manoeuvre in different body positions. Eur J Appl Physiol 61, 20–25 (1990). https://doi.org/10.1007/BF00236688
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DOI: https://doi.org/10.1007/BF00236688