Autonomic function testing: Compliance and consequences.

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  • Additional Information
    • Source:
      Publisher: Elsevier Country of Publication: Netherlands NLM ID: 100909359 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-7484 (Electronic) Linking ISSN: 15660702 NLM ISO Abbreviation: Auton Neurosci Subsets: MEDLINE
    • Publication Information:
      Original Publication: [Amsterdam ; New York] : Elsevier, c2000-
    • Subject Terms:
      Posture*/physiology ; Respiration* ; Valsalva Maneuver*/physiology; Autonomic Nervous System Diseases/*diagnosis; Air Pressure ; Autonomic Nervous System Diseases/physiopathology ; Blood Pressure/physiology ; Blood Pressure Determination ; Cardiography, Impedance ; Heart Rate/physiology ; Humans ; Male ; Odds Ratio ; Vital Capacity ; Young Adult
    • Abstract:
      Background: The deep breathing test (DB) and Valsalva maneuver (VM) are used to detect autonomic dysfunction. The VM induces sympathetically mediated changes in blood pressure (phase II late, phase IV, and recovery time) and both tests induce vagally mediated heart rate changes. There is limited information on effects of key variables, compliance with testing and the effects of non-compliance This study has twin goals of evaluating compliance with standard instructions and the effects of changes in key variables. We also evaluated the effect of position on the VM.
      Material and Methods: Forty healthy males performed DB at air exchange volumes of 50, 80, and 100% of vital lung capacity (VLC). The VM was performed at 40 and 30mmHg expiratory pressure for 15 and 10s in sitting and supine position, respectively.
      Results: Participants performed DB at lower volumes than intended and were not able to maintain 100% VLC for the duration of the test. The DB heart rate response decreased 6.3beats/min per liter below VLC. During the VM, subjects blew at lower pressures than instructed. The VM responses were significantly larger with longer expiration durations, higher expiratory pressures and when performed sitting. Performing the VM at 40mmHg for 10s in supine position increased the odds ratio of experiencing flat-top responses.
      Conclusion: The ability of subjects to strictly comply with methodological guidelines significantly improves results. Recording of both test parameters and ensuing results is suggested.
      (Copyright © 2017 Elsevier B.V. All rights reserved.)
    • Contributed Indexing:
      Keywords: Autonomic nervous system; Circulatory and respiratory physiological phenomena; Valsalva maneuver
    • Publication Date:
      Date Created: 20171107 Date Completed: 20180129 Latest Revision: 20180309
    • Publication Date:
      20221213
    • Accession Number:
      10.1016/j.autneu.2017.10.005
    • Accession Number:
      29107740