Noninvasive assessment of central circulatory pressures by analysis of ear densitographic changes during the valsalva maneuver

Luciano Bernardi, Riccardo Saviolo, David H. Spodick

Research output: Contribution to journalArticlepeer-review

Abstract

The ear densitogram was monitored in 21 consecutive patients with various degrees of myocardial function (New York Heart Association class I to IV) during the standardized Valsalva maneuver to evaluate the quantitative relations between the pattern of response and the central circulatory pressures. The ear densitographic first derivative consistently tracked the aortic pulse pressure during the strain phase of the Valsalva maneuver (beat-to-beat correlation [r] range 0.98 to 0.72). The percent decrease of the densitographic pulse derivative during strain correlated with left ventricular end-diastolic pressure at rest (r = 0.62, p <0.001), but not with cardiac output, cardiac index and ejection fraction. Multiple stepwise regression was used to take into account multiple aspects (time intervals and pulse amplitudes) of the pattern of response to the Valsalva maneuver. As a result, both correlations improved substantially (r = 0.97, p <0.001 for left ventricular end-diastolic pressure, and r = 0.92, p <0.001 for pulmonary artery wedge pressure). In conclusion, the combination of several noninvasive indexes obtained by pube amplitude and interval changes during the strain phase of the Valsalva maneuver seems to be a new and promising method for noninvasive evaluation of the status of left ventricular filing pressures.

Original languageEnglish
Pages (from-to)787-792
Number of pages6
JournalThe American Journal of Cardiology
Volume64
Issue number12
DOIs
Publication statusPublished - Oct 1 1989

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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