Haemodynamic Quantification of Different Provocation Manoeuvres by Simultaneous Measurement of Right and Left Atrial Pressure: Implications for the Echocardiographic Detection of Persistent Foramen Ovale
| Autor: | Stefan Pfleger, Asvin Latsch, S. Stark, B. Simonis, Martin Borggrefe, Wolfram Voelker, Burghard Schumacher, K. Konstantin Haase, Armin Scherhag |
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| Rok vydání: | 2001 |
| Předmět: |
Adult
Male medicine.medical_specialty Valsalva Maneuver medicine.medical_treatment Blood Pressure Internal medicine Heart Septum medicine Valsalva maneuver Humans Radiology Nuclear Medicine and imaging Heart Atria Prospective Studies Expiration Atrium (heart) Pulmonary wedge pressure Aged Aged 80 and over business.industry Respiration Hemodynamics Central venous pressure General Medicine Middle Aged Atrial Function medicine.disease Heart septum Blood pressure medicine.anatomical_structure Cough Anesthesia cardiovascular system Cardiology Patent foramen ovale Female Cardiology and Cardiovascular Medicine business Echocardiography Transesophageal |
| Zdroj: | European Journal of Echocardiography. 2:88-93 |
| ISSN: | 1525-2167 |
| Popis: | Persistent foramen ovale (PFO) is found in 9.2--32% of echocardiographic examinations. The gold standard for the detection of a PFO is transoesophageal echocardiography (TEE) and the mostly used provocation test is the Valsalva manoeuvre. The aim of our study was to evaluate the effectiveness of the Valsalva manoeuvre compared to other provocation tests by simultaneous haemodynamic measurements of the right and left atrial pressure.Fifty patients underwent Swan-Ganz catheterization. Right atrial pressure and pulmonary capillary wedge pressure, which corresponds to the left atrial pressure, were measured simultaneously. The following manoeuvres were compared: the Valsalva manoeuvre, coughing, deep inspiration and expiration pressures of 20 mmHg, 40 mmHg and 60 mmHg. The main objective of our study was to compare the occurrence of pressure gradients (right atrial pressureleft atrial pressure). For further quantification mean gradients, time duration of pressure overlap, as well as products of mean gradients and overlap time were analysed.During the Valsalva manoeuvre a significant pressure gradient could be observed in 84% of the patients, followed by an expiration pressure of 60 mmHg (82%), inspiration (78%), expiration pressure of 40 mmHg (76%), coughing (75%) and an expiration pressure of 20 mmHg (62%). Comparing the mean gradients and the products of mean gradients and overlap time duration during the different manoeuvres, we could detect the significantly best results with the Valsalva manoeuvre.The Valsalva manoeuvre might be the most effective test to provoke a right-to-left atrial shunt for the detection of a PFO during echocardiographic examinations. |
| Databáze: | OpenAIRE |
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