Somaini P, Deseö T, Hurni R, Marko P, Christen S, Koller R, Bachmann L M, Steurer J
Stadtspital Waid.
Praxis (Bern 1994). 2000 Jul 13;89(27-28):1137-41.
Many tests and examinations are used for diagnosing heart failure. Their accuracy tends to vary, echocardiography representing the gold standard. The Valsalva maneuver involves an easy-to-perform test for assessing the cardiac ejection fraction. The present study investigated the power of the Valsalva test in patients who received an echocardiography for various indications. A total of 153 patients were examined, some recruited from private practices, some from different hospitals. An echocardiographically measured left-ventricular ejection fraction of 45% was set as the limit value. 30 patients had an ejection fraction of less than 45%, signaling a relevant systolic dysfunction. The sensitivity of the Valsalva test for detecting impaired function was 70% and its specificity 72%. The positive predictive value was 39% and the negative predictive value 90%. This means that when the Valsalva test produces a normal result and the EKG is also normal, the likelihood that the patient has no relevant systolic dysfunction is very great. The Valsalva test is cost-effective, quick and easy to perform and useful for evaluating left-ventricular pump function.
