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Advan. Physiol. Edu. 32: 100-106, 2008; doi:10.1152/advan.00057.2007
1043-4046/08 $8.00
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ADV PHYSIOL EDUC 32:100-106, 2008
© 2008 American Physiological Society

TEACHING IN THE LABORATORY

Teaching cardiac autonomic function dynamics employing the Valsalva (Valsalva-Weber) maneuver

Luiz Fernando Junqueira, Jr.

Clinical Medicine Area, Cardiology, Cardiovascular Laboratory, Faculty of Medicine, University of Brasilia, and Division of Cardiology, University of Brasilia Hospital, Brasilia, Brazil

Address for reprint requests and other correspondence: L. F. Junqueira, Clinical Medicine Area, Cardiovascular Laboratory, Faculty of Medicine, Univ. of Brasilia, Brasilia DF 70910-900, Brazil (e-mail: lfjunq{at}unb.br)

In this report, a brief history of the Valsalva (Valsalva-Weber) maneuver is outlined, followed by an explanation on the use of this approach for the evaluation of cardiac autonomic function based on underlying heart rate changes. The most important methodological and interpretative aspects of the Valsalva-Weber maneuver are critically updated, and some guidelines are established for simple application of the maneuver in a teaching or research laboratory setting. These include the hemodynamic and cardiac autonomic mechanisms involved, technical aspects such as the intensity and duration of the expiratory straining, frequency of maneuver sessions, training and posture of the individuals tested, different time- and grade change-dependent indexes of heart interval variation, and clinical application of the maneuver.

Key words: cardiac autonomic function testing; baroreflex heart rate control; sympathetic and parasympathetic cardiac modulation






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