Original scientific paper
Can we predict complications after elective carotid artery angioplasty and stenting with a simple Valsalva test?
Viktor Švigelj
orcid.org/0000-0002-6144-5041
; Department of Vascular Neurology and Neurological Intensive Care, Neurological Intensive Care Unit, Division of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
Matjaž Šinkovec
; Department of Cardiology, Division of Internal Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
Viktor Avbelj
; Department of Communication Systems, Jozef Stefan Institute, Ljubljana, Slovenia
Roman Trobec
; Department of Communication Systems, Jozef Stefan Institute, Ljubljana, Slovenia
Abstract
Objectives. Arterial baroreflex plays a key role in short-term blood pressure balancing. It can also be quantified noninvasively with baroreceptor sensitivity during Valsalva manoeuver. The aim of the study was to evaluate the role of Valsalva manoeuver as a potential marker of possible autonomic dysfunction in patients after carotid artery angioplasty and stenting.
Materials and methods. We evaluated dynamic changes of blood pressure during Valsalva manoeuver (Valsalva ratio, adrenergic baroreceptor sensitivity) in 22 patients (11 male; 63.2 ± 6.7 years) with symptomatic, unilateral internal carotid artery stenosis, and compared results with age and sex matched control subjects.
Results. Valsalva ratio between baseline and post-procedural day (1.26 ± 0.13 vs 1.46 ± 0.31; p=0.002) was the only statistically significant parameter. All other tests (also between the study and the control group), cardiovagal and adrenergic, revealed no significant differences.
Conclusion. We were not able to show that Valsalva manoeuver, as a simple, non-invasive and easy to perform test, could reliably confirm patients who are at a risk for postprocedural complications. It seems that most of the compensatory mechanisms, occurring after a revascularisation procedure, remain largely unclarified.
Keywords
carotid stenosis; angioplasty; Valsalva manoeuver; baroreceptor sensitivity; Valsalva ratio
Hrčak ID:
140711
URI
Publication date:
1.4.2015.
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