Systolic blood pressure response to valsalva maneuver in cases of Chronic Obstructive Pulmonary disease

To observe the systolic blood pressure response to Valsalva maneuver in cases of chronic obstructive pulmonary disease [COPD]. To correlate the Valsalva responses with left ventricular ejection fraction [LVEF]. In all subjects the standard Valsalva maneuver was performed in the supine position and systolic blood pressure responses were characterized as a [a] Sinusoidal [Normal] [b] Absent over shoot and [c] Square wave [Abnormal]. LVEF was performed in all COPD subjects. Setting: Physiology Department BMSI, Medical Department, Chest Medicine Department J.P.M.C. and NICVD Karachi. A total of 95 male subjects were included, during the course of present study, out of which 30 subjects were healthy controls and 65 subjects were COPD with and without Cardiac failure. The Valsalva responses were strongly correlated with LVEF. Sinusoidal response was observed in all [100%] healthy control subjects, 21 [60%] of the 35 COPD subjects without cardiac failure and only 1 [3.33%] of 30 COPD subjects with cardiac failure, Absent overshoot was observed in 14 [40%] of the 35 COPD Subjects without Cardiac failure and 5 [16.67%] of the 30 COPD subjects with cardiac failure, square wave response was only observed in 24 [80%] of the 30 COPD subjects with cardiac failure. LVEF of 22 sinusoidal responses is 74.36 [ +/- 1.30], while 19 absent over shoot responses is 46.47 [ +/- 2.67] and 24 square wave responses is 29.67 [ +/- 1.69]. It is concluded that in the presence of physician systolic blood pressure response to Valsalva maneuver is a simple, safe and non-invasive technique than the more sophisticated test LVEF in early detection of cardiac failure