Autonomic function testing: Compliance and consequences

Thorsten Kamlarczyk Rasmussen, John Hansen, Phillip Anson Low, Paola Sandroni, Wolfgang Singer, Troels Staehelin Jensen, Astrid Juhl Terkelsen

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Background: The deep breathing test (DB) and Valsalva maneuver (VM) are used to detect autonomic dysfunction. The VM induces sympathetically mediated changes in blood pressure (phase II late, phase IV, and recovery time) and both tests induce vagally mediated heart rate changes. There is limited information on effects of key variables, compliance with testing and the effects of non-compliance This study has twin goals of evaluating compliance with standard instructions and the effects of changes in key variables. We also evaluated the effect of position on the VM. Material and methods: Forty healthy males performed DB at air exchange volumes of 50, 80, and 100% of vital lung capacity (VLC). The VM was performed at 40 and 30. mm. Hg expiratory pressure for 15 and 10. s in sitting and supine position, respectively. Results: Participants performed DB at lower volumes than intended and were not able to maintain 100% VLC for the duration of the test. The DB heart rate response decreased 6.3. beats/min per liter below VLC. During the VM, subjects blew at lower pressures than instructed. The VM responses were significantly larger with longer expiration durations, higher expiratory pressures and when performed sitting. Performing the VM at 40. mm. Hg for 10. s in supine position increased the odds ratio of experiencing flat-top responses. Conclusion: The ability of subjects to strictly comply with methodological guidelines significantly improves results. Recording of both test parameters and ensuing results is suggested.

Original languageEnglish (US)
JournalAutonomic Neuroscience: Basic and Clinical
DOIs
StateAccepted/In press - 2017

Keywords

  • Autonomic nervous system
  • Circulatory and respiratory physiological phenomena
  • Valsalva maneuver

ASJC Scopus subject areas

  • Endocrine and Autonomic Systems
  • Clinical Neurology
  • Cellular and Molecular Neuroscience

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