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research-article

Modeling pathological hemodynamic responses to the Valsalva maneuver

[+] Author and Article Information
Leszek Pstras

Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences Ks. Trojdena 4, 02-109 Warsaw, Poland
leszek.pstras@ibib.waw.pl

Karl Thomaseth

Institute of Electronics, Computer and Telecommunication Engineering, National Research Council, c/o Department of Information Engineering (DEI) Via G. Gradenigo 6/b, 35131 Padova, Italy
karl.thomaseth@ieiit.cnr.it

Jacek Waniewski

Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences Ks. Trojdena 4, 02-109 Warsaw, Poland
jacek.waniewski@ibib.waw.pl

Italo Balzani

Departament of Medicine, Sant'Antonio Hospital Via Jacopo Facciolati 71, 35127 Padova, Italy
italo.balzani@sanita.padova.it

Federico Bellavere

Rizzola Foundation Hospital Via Gorizia 1, 30027 San Donà di Piave (Venezia), Italy
bellavere@rizzola.it

1Corresponding author.

ASME doi:10.1115/1.4036258 History: Received April 24, 2016; Revised March 03, 2017

Abstract

The Valsalva maneuver consisting in a forced expiration against closed airways is one of the most popular clinical tests of the autonomic nervous system function. When properly performed by a healthy subject, it features four characteristic phases of arterial blood pressure and heart rate variations, based on the magnitude of which the autonomic function may be assessed qualitatively and quantitatively. In patients with some disorders or in healthy patients subject to specific conditions, the pattern of blood pressure and heart rate changes during the execution of the Valsalva maneuver may, however, differ from the typical sinusoidal-like pattern. Several types of such abnormal responses are well known and correspond to specific physiological conditions. In this paper we use our earlier mathematical model of the cardiovascular response to the Valsalva maneuver to show that such pathological responses may be simulated by changing individual model parameters or adding new parameters with a clear physiological meaning. The simulation results confirm the adaptability of our model and its usefulness for diagnostic or educational purposes.

Copyright (c) 2017 by ASME
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