Valsalva maneuver procedures in the diagnosis of right-to-left shunt by contrast-enhanced transcranial doppler using agitated saline solution with blood as a contrast agent

Lange, Marcos Christiano; Zétola, Viviane Flumignan; Piovesan, Élcio Juliato; Werneck, Lineü Cesar

doi:10.1590/s0004-282x2010000300016

Cited by 4 publications

(2 citation statements)

References 12 publications

(15 reference statements)

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“…There was an interval of at least 10 minutes between the two methods. Patients were also instructed to perform an effective Valsalva maneuver before the tests in order to reach and maintain a pressure of 40 mmHg for at least 5 seconds[19, 24, 25]. This was performed by blowing into the plastic pipe connected to the manometer device.…”

Section: Methodsmentioning

confidence: 99%

Modified Method of Contrast Transthoracic Echocardiography for the Diagnosis of Patent Foramen Ovale

Zhao

Xie

et al. 2019

BioMed Research International

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Purpose. To compare the sensitivity and specificity of modified and traditional methods of contrast echocardiography of the right portion of the heart in patients with a suspicion of patent foramen ovale (PFO). Methods. The study population consisted of 506 patients with high clinical suspicion of PFO. The traditional Valsalva maneuver consists of expiration against a closed glottis after a full inspiration. A modified Valsalva maneuver was performed with a handmade pressure monitoring device, which measured pressure during performance of the Valsalva maneuver. Modified and traditional methods of contrast echocardiography were performed among all patients. Contrast transesophageal echocardiography (TEE) was regarded as the gold standard. Results. A total of 279 patients with PFO were confirmed by TEE. 259 cases (sensitivity: 92.83%) were detected by a modified method of contrast echocardiography of the right portion of the heart, while 234 cases were detected using the traditional method (sensitivity: 83.87%). The sensitivity of modified contrast echocardiography of the right portion of the heart was significantly higher than that of the traditional method (92.83% vs. 83.87%, P=0.001). However, there was no significant difference in the specificity of the two methods for the diagnosis of PFO (97.35% vs. 96.03%, P=0.431). Additionally, the results of semiquantitative evaluation of PFO using modified method failed to show a more positive rate than shown by the traditional method (Z=−1.782, P=0.075). Conclusions. Modified contrast echocardiography of the right portion of the heart yielded a higher sensitivity than the traditional method, which contributed to the diagnosis of cardiac PFO. The research was a part of a register study (https://register.clinicaltrials.gov/ ClinicalTrials ID: NCT02777359).

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Section: Methodsmentioning

confidence: 99%

Modified Method of Contrast Transthoracic Echocardiography for the Diagnosis of Patent Foramen Ovale

Zhao

Xie

et al. 2019

BioMed Research International

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“…In addition, although some countries have issued corresponding guidelines or consensus ( 22 , 23 ), there are still disputes over some details. For example, the choice of Valsalva implementation time during cTCD, although most recommended after contrast agent (CA) injection, some studies recommended before or during CA injection and different implementation times, will lead to completely different examination results ( 24 , 25 ). Another example, most previous studies diagnosed PFO by echocardiography only using left heart contrast and cardiac cycles after right atrium (RA) opacification, but the definition for quantity of left heart contrast and cardiac cycles varies among studies ( 20 ).…”

Section: The Diagnosis Of Pfomentioning

confidence: 99%

Recent progress in patent foramen ovale and related neurological diseases: A narrative review

Shi

Sha²,

Li³

et al. 2023

Front. Neurol.

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Patent foramen ovale (PFO) is a common congenital cardiac abnormality when the opening of the interatrial septum is not closed in adulthood. This abnormality affects 25% of the general population. With the development of precision medicine, an increasing number of clinical studies have reported that PFO is closely related to various neurological diseases such as stroke, migraine, obstructive sleep apnea, and decompression syndrome. It has also been suggested that PFO closure could be effective for preventing and treating these neurological diseases. Therefore, increasing attention has been given to the prevention, diagnosis, and treatment of PFO-related neurological diseases. By reviewing existing literature, this article focuses on the pathogenesis, epidemiology, and clinical characteristics of PFO-related neurological diseases, as well as the prevention and treatment of different neurological diseases to discuss, and aims to provide current progress for this field and decision-making evidence for clinical practice.

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Different Valsalva Manoeuvre Procedures for the Diagnosis of Right-to-Left Shunt by Contrast-Transcranial Doppler

Liu

Teng

Zhai

et al. 2017

Ultrasound in Medicine & Biology

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Valsalva maneuver procedures in the diagnosis of right-to-left shunt by contrast-enhanced transcranial doppler using agitated saline solution with blood as a contrast agent

Cited by 4 publications

References 12 publications

Modified Method of Contrast Transthoracic Echocardiography for the Diagnosis of Patent Foramen Ovale

Modified Method of Contrast Transthoracic Echocardiography for the Diagnosis of Patent Foramen Ovale

Recent progress in patent foramen ovale and related neurological diseases: A narrative review

Different Valsalva Manoeuvre Procedures for the Diagnosis of Right-to-Left Shunt by Contrast-Transcranial Doppler

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