Comparison of Different Methods of Valsalva Maneuver for Right-to-left Shunt Detection by Contrast-Enhanced Transcranial Doppler
Abstract We evaluated 298 patients for right-to-left shunt (RLS) detection by contrast-enhanced transcranial Doppler at rest state (RS), during the conventional Valsalva maneuver (CM), and during the modified Valsalva maneuver (BM: blowing into the connecting tube of a sphygmomanometer at 40 mm Hg f...
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| Veröffentlicht in: | Ultrasound in medicine & biology 2016-05, Vol.42 (5), p.1124-1129 |
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| container_title | Ultrasound in medicine & biology |
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| creator | Guo, Yu-Zhu Gao, Yong-Sheng Guo, Zhen-Ni Niu, Peng-Peng Yang, Yi Xing, Ying-Qi |
| description | Abstract We evaluated 298 patients for right-to-left shunt (RLS) detection by contrast-enhanced transcranial Doppler at rest state (RS), during the conventional Valsalva maneuver (CM), and during the modified Valsalva maneuver (BM: blowing into the connecting tube of a sphygmomanometer at 40 mm Hg for 10 s) in random order, and the degree of RLS along the time of the first microbubble occurrence was recorded. The positive rates were 21.8%, 36.9% and 47.3% for RS, CM and BM, respectively ( p |
| doi_str_mv | 10.1016/j.ultrasmedbio.2015.12.020 |
| format | Article |
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The positive rates were 21.8%, 36.9% and 47.3% for RS, CM and BM, respectively ( p < 0.001). BM resulted in a significantly higher positive rate ( p = 0.010), and there was a significant difference between the two different methods of VM in terms of the degree of RLS detection ( p < 0.001). Further, the first microbubble occurred later during BM than CM (10.22 ± 3.77 s vs. 9.44 ± 4.36 s, p < 0.05). This modified maneuver is an alternative to the conventional one, especially for those who cannot perform the conventional maneuver adequately, but are highly suspected of having RLS.</description><identifier>ISSN: 0301-5629</identifier><identifier>EISSN: 1879-291X</identifier><identifier>DOI: 10.1016/j.ultrasmedbio.2015.12.020</identifier><identifier>PMID: 26928233</identifier><language>eng</language><publisher>England: Elsevier Inc</publisher><subject>Adult ; Algorithms ; Contrast-enhanced transcranial Doppler ; Female ; Foramen Ovale, Patent - diagnostic imaging ; Humans ; Image Enhancement - methods ; Image Interpretation, Computer-Assisted - methods ; Male ; Radiology ; Reproducibility of Results ; Right-to-left shunt ; Sensitivity and Specificity ; Ultrasonography, Doppler, Transcranial - methods ; Valsalva Maneuver</subject><ispartof>Ultrasound in medicine & biology, 2016-05, Vol.42 (5), p.1124-1129</ispartof><rights>World Federation for Ultrasound in Medicine & Biology</rights><rights>2016 World Federation for Ultrasound in Medicine & Biology</rights><rights>Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c468t-f016b90d50deece4b60b6bf197930090c3e6abc44bd27f3696a8f8dda3b175c93</citedby><cites>FETCH-LOGICAL-c468t-f016b90d50deece4b60b6bf197930090c3e6abc44bd27f3696a8f8dda3b175c93</cites><orcidid>0000-0003-0680-1821</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ultrasmedbio.2015.12.020$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26928233$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Guo, Yu-Zhu</creatorcontrib><creatorcontrib>Gao, Yong-Sheng</creatorcontrib><creatorcontrib>Guo, Zhen-Ni</creatorcontrib><creatorcontrib>Niu, Peng-Peng</creatorcontrib><creatorcontrib>Yang, Yi</creatorcontrib><creatorcontrib>Xing, Ying-Qi</creatorcontrib><title>Comparison of Different Methods of Valsalva Maneuver for Right-to-left Shunt Detection by Contrast-Enhanced Transcranial Doppler</title><title>Ultrasound in medicine & biology</title><addtitle>Ultrasound Med Biol</addtitle><description>Abstract We evaluated 298 patients for right-to-left shunt (RLS) detection by contrast-enhanced transcranial Doppler at rest state (RS), during the conventional Valsalva maneuver (CM), and during the modified Valsalva maneuver (BM: blowing into the connecting tube of a sphygmomanometer at 40 mm Hg for 10 s) in random order, and the degree of RLS along the time of the first microbubble occurrence was recorded. The positive rates were 21.8%, 36.9% and 47.3% for RS, CM and BM, respectively ( p < 0.001). BM resulted in a significantly higher positive rate ( p = 0.010), and there was a significant difference between the two different methods of VM in terms of the degree of RLS detection ( p < 0.001). Further, the first microbubble occurred later during BM than CM (10.22 ± 3.77 s vs. 9.44 ± 4.36 s, p < 0.05). This modified maneuver is an alternative to the conventional one, especially for those who cannot perform the conventional maneuver adequately, but are highly suspected of having RLS.</description><subject>Adult</subject><subject>Algorithms</subject><subject>Contrast-enhanced transcranial Doppler</subject><subject>Female</subject><subject>Foramen Ovale, Patent - diagnostic imaging</subject><subject>Humans</subject><subject>Image Enhancement - methods</subject><subject>Image Interpretation, Computer-Assisted - methods</subject><subject>Male</subject><subject>Radiology</subject><subject>Reproducibility of Results</subject><subject>Right-to-left shunt</subject><subject>Sensitivity and Specificity</subject><subject>Ultrasonography, Doppler, Transcranial - methods</subject><subject>Valsalva Maneuver</subject><issn>0301-5629</issn><issn>1879-291X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNUk1vEzEUtBCIhsJfQBYnLrv1R9a75oCEkkKRWiHRgrhZtveZOGzWwfZGyo2fjlcpCHHqxZbsmXnvzTyEXlFSU0LFxbaehhx12kFvfKgZoU1NWU0YeYQWtGtlxST99hgtCCe0agSTZ-hZSltCSCt4-xSdMSFZxzhfoF-rsNvr6FMYcXB47Z2DCGPGN5A3oU_z41c9JD0cNL7RI0wHiNiFiD_775tc5VAN4DK-3UyFtIYMNvuiZY54Fca5y1xdjhs9WujxXdRjsuXwesDrsN8PEJ-jJ67ow4v7-xx9eX95t7qqrj99-Lh6d13Zpehy5crgRpK-IT2AhaURxAjjqGwlJ0QSy0FoY5dL07PWcSGF7lzX95ob2jZW8nP0-qS7j-HnBCmrnU8WhqHMFKakaCuJFIKzh0DblrSN4F2BvjlBbQwpRXBqH_1Ox6OiRM1hqa36Nyw1h6UoUyWsQn55X2cy5fsv9U86BbA-AaAYc_AQVbIeZit9LD6rPviH1Xn7n4wd_OitHn7AEdI2THEs1iuqUiGo23lt5q2homwMaTj_DUo0w6g</recordid><startdate>20160501</startdate><enddate>20160501</enddate><creator>Guo, Yu-Zhu</creator><creator>Gao, Yong-Sheng</creator><creator>Guo, Zhen-Ni</creator><creator>Niu, Peng-Peng</creator><creator>Yang, Yi</creator><creator>Xing, Ying-Qi</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><orcidid>https://orcid.org/0000-0003-0680-1821</orcidid></search><sort><creationdate>20160501</creationdate><title>Comparison of Different Methods of Valsalva Maneuver for Right-to-left Shunt Detection by Contrast-Enhanced Transcranial Doppler</title><author>Guo, Yu-Zhu ; Gao, Yong-Sheng ; Guo, Zhen-Ni ; Niu, Peng-Peng ; Yang, Yi ; Xing, Ying-Qi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c468t-f016b90d50deece4b60b6bf197930090c3e6abc44bd27f3696a8f8dda3b175c93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Algorithms</topic><topic>Contrast-enhanced transcranial Doppler</topic><topic>Female</topic><topic>Foramen Ovale, Patent - diagnostic imaging</topic><topic>Humans</topic><topic>Image Enhancement - methods</topic><topic>Image Interpretation, Computer-Assisted - methods</topic><topic>Male</topic><topic>Radiology</topic><topic>Reproducibility of Results</topic><topic>Right-to-left shunt</topic><topic>Sensitivity and Specificity</topic><topic>Ultrasonography, Doppler, Transcranial - methods</topic><topic>Valsalva Maneuver</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Guo, Yu-Zhu</creatorcontrib><creatorcontrib>Gao, Yong-Sheng</creatorcontrib><creatorcontrib>Guo, Zhen-Ni</creatorcontrib><creatorcontrib>Niu, Peng-Peng</creatorcontrib><creatorcontrib>Yang, Yi</creatorcontrib><creatorcontrib>Xing, Ying-Qi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>Ultrasound in medicine & biology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Guo, Yu-Zhu</au><au>Gao, Yong-Sheng</au><au>Guo, Zhen-Ni</au><au>Niu, Peng-Peng</au><au>Yang, Yi</au><au>Xing, Ying-Qi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of Different Methods of Valsalva Maneuver for Right-to-left Shunt Detection by Contrast-Enhanced Transcranial Doppler</atitle><jtitle>Ultrasound in medicine & biology</jtitle><addtitle>Ultrasound Med Biol</addtitle><date>2016-05-01</date><risdate>2016</risdate><volume>42</volume><issue>5</issue><spage>1124</spage><epage>1129</epage><pages>1124-1129</pages><issn>0301-5629</issn><eissn>1879-291X</eissn><abstract>Abstract We evaluated 298 patients for right-to-left shunt (RLS) detection by contrast-enhanced transcranial Doppler at rest state (RS), during the conventional Valsalva maneuver (CM), and during the modified Valsalva maneuver (BM: blowing into the connecting tube of a sphygmomanometer at 40 mm Hg for 10 s) in random order, and the degree of RLS along the time of the first microbubble occurrence was recorded. The positive rates were 21.8%, 36.9% and 47.3% for RS, CM and BM, respectively ( p < 0.001). BM resulted in a significantly higher positive rate ( p = 0.010), and there was a significant difference between the two different methods of VM in terms of the degree of RLS detection ( p < 0.001). Further, the first microbubble occurred later during BM than CM (10.22 ± 3.77 s vs. 9.44 ± 4.36 s, p < 0.05). This modified maneuver is an alternative to the conventional one, especially for those who cannot perform the conventional maneuver adequately, but are highly suspected of having RLS.</abstract><cop>England</cop><pub>Elsevier Inc</pub><pmid>26928233</pmid><doi>10.1016/j.ultrasmedbio.2015.12.020</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-0680-1821</orcidid></addata></record> |
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| subjects | Adult Algorithms Contrast-enhanced transcranial Doppler Female Foramen Ovale, Patent - diagnostic imaging Humans Image Enhancement - methods Image Interpretation, Computer-Assisted - methods Male Radiology Reproducibility of Results Right-to-left shunt Sensitivity and Specificity Ultrasonography, Doppler, Transcranial - methods Valsalva Maneuver |
| title | Comparison of Different Methods of Valsalva Maneuver for Right-to-left Shunt Detection by Contrast-Enhanced Transcranial Doppler |
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