Effects of the Valsalva maneuver on pial artery pulsation and subarachnoid width in healthy adults

Wszędybył-Winklewska, Magdalena; Frydrychowski, Andrzej F.; Michalska, Beata; Winklewski, Paweł J.

doi:10.1016/j.mvr.2011.08.003

Cited by 13 publications

(21 citation statements)

References 24 publications

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“…There were no significant differences between sexes. Full descriptive statistics are available in our previous publication [4]. The arterial pressure and HR results were consistent with previous reports [1,5].…”

Section: Resultssupporting

confidence: 88%

“…Increases in sympathetic muscle-nerve activity triggered by VM are proportional to the level of straining [1]. Our study was initially designed to study changes in brain microcirculation during VM [4]. Therefore, we tried to minimise potential bias caused by simultaneous sympathetic activation, so the expiratory pressure was kept at 20 mmHg instead of the more commonly used 40 mmHg.…”

Section: Discussionmentioning

confidence: 99%

“…This and the previous study [1] demonstrate that arterial pressure transiently lasting only seconds changes the relations between arterial pressure and vagal neural outflows. However, it should be noted that VM is associated with significant changes in cerebral blood flow [7], brain microcirculation [4] and intracranial pressure [8]. Therefore, an input from the central nervous system into the baroreceptor reflex cannot be excluded.…”

Section: Discussionmentioning

confidence: 99%

“…Actually, sensitisation of the vagal baroreceptor unload reflex seen in our study immediately after the release of straining may represent an attempt to maintain arterial pressure. In contrast, reset to lower pressure of the cardiovagal reflex described by Smith et al [1] 60 seconds after the release of straining maybe seen as a protective mechanism to limit abundant cerebral blood flow [7] and associated risk when small arter ioles dilated in VM3 are not able to quickly compensate huge blood volume gain caused by blood pressure increase in VM4 [4]. However, a well-designed experimental study is needed to verify this hypothesis and further assess the role of rapid baroreceptor reset and sensitivity change in the maintenance of brain circulation homeostasis.…”

Section: Discussionmentioning

confidence: 99%

“…We hypothesised that cardiovagal baroreceptor unload reflex sensitivity may increase between VM2E and VM3. To verify this hypothesis we performed a retrospective analysis of data from our previous study [4]. Baroreceptor-heart rate reflex gain was defined as the slope of the relationship of change in heart rate (DHR) to change in systolic arterial pressure (DSBP) during VM2E and VM3.…”

Section: Introductionmentioning

confidence: 99%

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Próba Valsavy zwiększa czułość składowej przywspółczulnej odruchu spowodowanego odbarczeniem baroreceptorów u młodych zdrowych osób

Wszędybył-Winklewska

Frydrychowski

Winklewski

2017

Arterial Hypertension

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Introduction. The objective was to verify the hypothesis that change in cardiovagal baroreceptor unload reflex sensitivity occurs between early phase 2 (VM2E) and phase 3 (VM3) of the Valsalva manoeuvre (VM). The study was performed on 29 volunteers between the ages of 25 and 40 (29.3 ± SE 4.0). Material and methods. The experimental scheme was as follows: rest in sitting position, VM in sitting position maintaining an expiratory pressure of 20 mm Hg for 15 seconds, rest in sitting position. Changes in systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were measured using Finapres. Results. In VM2E and VM3, HR increased (+51.76 ± SE 4.06 beats/min., p < 0.001; +37.77 ± SE 8.65 beats/min., p < 0.0001, respectively) in response to a fall in SBP (-47.55 ± SE 3.95 mmHg, p < 0.001; -29.66 ± SE 2.80 mmHg, p < 0.0001; respectively). Both events of baroreceptor unload have been observed within the very similar range of SBP and HR. Conclusion. The slope of regression relating change in heart rate (DHR) and systolic arterial pressure (DSBP) was significantly higher in VM3 (DHR 2 = -1.063 × DSBP2 + 7.0986) than in VM2E (DHR 1 = -0.4395 × DSBP2 + 30.862), suggesting the increased baroreceptors' sensitivity toward SBP fall in VM3 compared to VM2E. VM increases vagal baroreceptor unloads reflex sensitivity.

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Section: Resultssupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Próba Valsavy zwiększa czułość składowej przywspółczulnej odruchu spowodowanego odbarczeniem baroreceptorów u młodych zdrowych osób

Wszędybył-Winklewska

Frydrychowski

Winklewski

2017

Arterial Hypertension

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Coupling of Blood Pressure and Subarachnoid Space Oscillations at Cardiac Frequency Evoked by Handgrip and Cold Tests: A Bispectral Analysis

Gruszecki

Tkachenko

Kot

et al. 2018

Advances in Medicine and Medical Research

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A unifying hypothesis for hydrocephalus and the Chiari malformations part two: The hydrocephalus filling mechanism

Williams

2016

Medical Hypotheses

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It is proposed that negative central nervous system (CNS) pressure is one of the filling mechanisms of the fluid spaces of the CNS. Negative CNS pressure is caused by the combination of gravitational force and body movement. The venous system imposes pressure fluctuations on the CNS due to changes in posture and body cavity pressure. It is proposed here that filling of veins, arteries and cerebrospinal (CSF) spaces are all assisted by negative CNS pressure. Hyperemia in the CNS in response to pressure changes with movement was described in the first part of this hypothesis. By this means parenchyma water levels may increase (Williams, 2008). In the developmental forms of hydrocephalus expansion of CSF spaces is a more prominent feature than parenchyma water changes. This feature is explained by this second part of the hypothesis where the negative pulsatility of pressure that can accompany positive pressure pulsatility, which occurs with body movement, is described as the pathological force that leads to cavity filling. When CNS compliance is lost there is overrepresentation of low and well as high pressure pulsations in response to body movements. Pressure that leads to the development of hydrocephalus can be described as being abnormally labile. Negative CNS pressure causes cavity filling in an analogous way to pleural cavity filling, with water passing from parenchyma tissue. Positive pressure within the pressure profile may cause expansion of regions of the CNS skeletal system that are able to grow such as the cranial vault so that large head size is a frequent accompaniment to hydrocephalus that is caused by this mechanism. Hydrocephalic disorders that are characterised by negative pressure filling mechanism often have a skeletal anatomical abnormality that causes reduced CNS compliance and adversely affect neural development. This is often in the form of obstruction to CSF flow around the base of the brain that then leads to vault expansion by means of high pressure pulsation and ventricle enlargement by means of low pressure pulsation. In health pressure pulsatility does not lead to enduring changes in water distribution within the CNS compartments but it assists physiological water balance.

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Effects of the Valsalva maneuver on pial artery pulsation and subarachnoid width in healthy adults

Cited by 13 publications

References 24 publications

Próba Valsavy zwiększa czułość składowej przywspółczulnej odruchu spowodowanego odbarczeniem baroreceptorów u młodych zdrowych osób

Próba Valsavy zwiększa czułość składowej przywspółczulnej odruchu spowodowanego odbarczeniem baroreceptorów u młodych zdrowych osób

Coupling of Blood Pressure and Subarachnoid Space Oscillations at Cardiac Frequency Evoked by Handgrip and Cold Tests: A Bispectral Analysis

A unifying hypothesis for hydrocephalus and the Chiari malformations part two: The hydrocephalus filling mechanism

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