Labovitz A J, Dincer B, Mudd G, Aker U T, Kennedy H L
Am Heart J. 1985 Feb;109(2):259-64. doi: 10.1016/0002-8703(85)90592-7.
To determine the effects of the Valsalva maneuver on global and regional left ventricular function, single-plane left ventriculograms were performed in the 30-degree right anterior oblique projection in 50 patients during normal breath holding and during the late strain phase of the Valsalva maneuver. Thirty-one patients had significant coronary artery disease (greater than 70% luminal narrowing in a major coronary artery). Ventriculograms were analyzed for determination of ejection fraction, end-diastolic, and end-systolic volumes. Regional wall motion was analyzed by a chord method of calculating segmental fractional shortening. Ejection fraction increased significantly in the entire group of patients (62 +/- 16% to 70 +/- 19%, p less than 0.0001), while both end-diastolic (105 +/- 33 cc to 88 +/- 34 cc, p less than 0.0001) and end-systolic volumes (43 +/- 29 cc to 30 +/- 29 cc, p less than 0.0001) showed striking reductions with Valsalva maneuver. Patients without significant coronary disease usually exhibited global augmentation in left ventricular function, while those with coronary disease often exhibited only segmental improvement. This augmentation appeared to be dependent on the patency of the supplying coronary vessel.
为了确定瓦尔萨尔瓦动作对左心室整体和局部功能的影响，对50例患者在正常屏气时以及瓦尔萨尔瓦动作的晚期应变阶段进行了30度右前斜位单平面左心室造影。31例患者患有严重冠状动脉疾病（主要冠状动脉管腔狭窄大于70%）。对心室造影进行分析以确定射血分数、舒张末期和收缩末期容积。采用弦法计算节段性缩短分数来分析局部室壁运动。整个患者组的射血分数显著增加（从62±16%增至70±19%，p<0.0001），而瓦尔萨尔瓦动作时舒张末期容积（从105±33ml降至88±34ml，p<0.0001）和收缩末期容积（从43±29ml降至30±29ml，p<0.0001）均显著减少。无严重冠状动脉疾病的患者通常表现为左心室功能整体增强，而患有冠状动脉疾病的患者往往仅表现为局部改善。这种增强似乎取决于供血冠状动脉的通畅情况。
