Evaluation of the heart rate response to the Valsalva maneuver

A study has been made of the heart rate (HR) response to the Valsalva maneuver in five different groups of normal white males and two groups of male coronary heart disease (CHD) patients using non-invasive methods. By means of the analysis of variance the effects of age, posture, Valsalva phase and CHD on the HR response were assessed. Both age and CHD were factors that reduce the HR response. Further analysis indicated that the HR change from Phase 3 to Phase 4 in the Valsalva was the preferred discriminator between normals and cardiac patients. We have derived a "Valsalva score" that can be used to identify HR changes that deviate from the expected average normal response for a given age, control HR and Phase 3 HR. HR assessment of the Valsalva maneuver is a simple safe non-invasive test. An abnormal response suggests altered functioning of hemodynamic or autonomic cardiovascular mechanisms governing HR control.