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Mayne's sign is mainly related to younger age and not to aortic regurgitation

Michael Happes1, Haroon Kamran, Louis Salciccioli

  • 1Division of Cardiovascular Medicine, State University of New York Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.

Blood Pressure Monitoring
|October 28, 2010
PubMed

Insights

Mayne's sign, an exaggerated drop in diastolic blood pressure (DBP) when raising the arm, is not a reliable indicator of aortic regurgitation (AR). This study found DBP changes are linked to age, not AR severity.

Area of Science:

  • Cardiology
  • Diagnostic Medicine
  • Medical Physiology

Background:

  • Mayne's sign, characterized by a significant diastolic blood pressure (DBP) decrease upon arm elevation, has been historically associated with severe chronic aortic regurgitation (AR).
  • This clinical sign predates advanced diagnostic tools like Doppler echocardiography.

Purpose of the Study:

  • To investigate the correlation between Doppler echocardiography-confirmed aortic regurgitation (AR) and changes in diastolic blood pressure (DBP) during upper extremity raising.
  • To evaluate the diagnostic utility of Mayne's sign in the context of modern echocardiographic assessment of AR.

Main Methods:

  • A prospective study involving 30 healthy controls and 40 patients with varying degrees of AR (mild to severe).
  • Diastolic blood pressure (DBP) was measured before and during the maneuver of raising the upper extremities in all participants.
  • Doppler echocardiography was used to quantify the severity of aortic regurgitation (AR).

Main Results:

  • The study found no significant correlation between the change in DBP upon arm raising and the presence or severity of AR as determined by Doppler echocardiography (r=-0.10, P=0.42).
  • A significant inverse correlation was observed between DBP change and patient age (r=-0.41, P<0.001), indicating younger individuals experienced greater DBP drops.
  • These findings challenge the traditional interpretation of Mayne's sign.

Conclusions:

  • The decrease in diastolic blood pressure (DBP) during arm elevation is primarily influenced by patient age, not the presence or severity of aortic regurgitation (AR).
  • Mayne's sign is not a reliable indicator for diagnosing or assessing the severity of aortic regurgitation (AR).
  • Clinicians should rely on Doppler echocardiography for accurate AR assessment rather than this physical examination finding.
Abstract

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