Six male patients with narcolepsy for several years, were studied without and with amphetamine in order to evaluate possible abnormalities in autonomic control of the cardiovascular system. Studies were made of (1) heart rate and blood flow in the resting forearm during contralateral isometric handgrip, (2) respiratory sinus arrhythmia and (3) heart rate response to the Valsalva manoeuvre. The ...

Arterial pulse pressure response during the strain phase of the Valsalva maneuver has been proposed as a clinical tool for the diagnosis of left heart failure, whereas responses of subjects with preserved systolic function have been poorly documented. We studied the relationship between the aortic pulse amplitude ratio (i.e., minimum/maximum pulse pressure) during the strain phase of the Valsal...

A 61-year-old man was admitted to the hospital because of orthopnea and was diagnosed with heart failure with a continuous heart murmur. A transthoracic echocardiogram revealed turbulent flow from the right coronary sinus of Valsalva to the right atrium throughout the cardiac cycle. Aortography confirmed the presence of a shunt jet from the right coronary sinus of Valsalva to the right atrium. ...

The three Valsalva sinuses are hollow structures named after the corresponding aortic valve cusps. Valsalva sinus aneurysms are relatively rare (0.14-0.23%), congenital or acquired, the most common being congenital, most often affecting the right coronary sinus. They also may be secondary to bacterial endocarditis, syphilis, atherosclerosis, aortic dissection, Marfan syndrome or as a result of ...

BACKGROUND AND PURPOSE The objective of this study was to find a sensitive method for the early detection of diabetic polyneuropathy (DPN) and determine the relationship between the functions of somatic and autonomic small nerve fibers in DPN. METHODS Patients with type 2 diabetes mellitus and DPN based on clinical symptoms, signs, intraepidermal nerve fiber density (IENFD), and findings in t...

BACKGROUND A noninvasive system for determining left ventricular (LV) filling pressure may help to improve personalized fluid removal goals in hemodialysis patients. We previously showed that the change in photoplethysmography (PPG) pulse amplitude measured by finger PPG during a Valsalva maneuver correlates with invasively measured left ventricular end-diastolic pressure (LVEDP). This key PPG ...

BACKGROUND In the presence of elevated cardiac filling pressures, the decline of blood pressure (BP) during the straining phase of a Valsalva manoeuvre is blunted or absent. We compared the use of non-invasively measured BP response to a Valsalva manoeuvre with clinical assessment and bioimpedance measurements to identify haemodialysis patients at risk of acute congestive heart failure (CHF). ...

OBJECTIVE This study was designed to define the degree of stretch/strain required of the levator hiatus in childbirth. There have been attempts at defining the distension required for vaginal childbirth with the help of individual data sets, but from previous work it is clear that hiatal dimensions and distensibility are likely to vary greatly between individuals. DESIGN Retrospective observa...