ArticleNeurology2011
Assessment of sympathetic index from the Valsalva maneuver.
Article in Neurology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 1 of them a synthesis that pooled it.
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Who cites it
42 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Hemodynamic orthostatic dizziness/vertigo: Diagnostic criteria.Journal of vestibular research : equilibrium & orientationGuideline
- Use of Valsalva Maneuver to Detect Late-Onset Delayed Orthostatic Hypotension.Hypertension (Dallas, Tex. : 1979) · 2023Trial
- Cerebral vasomotor reactivity during hypo- and hypercapnia across the adult lifespan.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2020Trial
- Influence of a neck compression collar on cerebrovascular and autonomic function in men and women.PloS one · 2019Trial
- Effects of Respiratory Training on Heart Rate Variability and Baroreflex Sensitivity in Individuals With Chronic Spinal Cord Injury.Archives of physical medicine and rehabilitation · 2018Trial
- Resistance exercise with combined Valsalva manoeuvre acutely increases carotid-femoral pulse wave velocity in healthy untrained individuals.European journal of applied physiology · 2026Article
- Concomitant Dysregulation of Cerebral Vasoreactivity and Arterial Blood Pressure Is Closely Related in Patients with Carotid Stenosis.Life (Basel, Switzerland) · 2026Article
- Shared autonomic phenotype of long COVID and myalgic encephalomyelitis/chronic fatigue syndrome.PloS one · 2026Article
- The effect of high-dose long-term therapy of intravenous immunoglobulins in autoimmune autonomic and sensory small fiber neuropathy: a retrospective open-label controlled study.Scientific reports · 2025Article
- Neurocardiology - from basics to clinic.World journal of cardiology · 2025Review
- Complex Characterization of Cerebral Vasoreactivity in Internal Carotid Artery Stenotic Patients with Transcranial Doppler Sonography.Life (Basel, Switzerland) · 2025Article
- Responses to Valsalva's maneuver in spinal cord injury do not broadly relate to vasoconstrictor capacity.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2024Article
- Mismatch between subjective and objective dysautonomia.Scientific reports · 2024Article
- Orthostatic intolerance with tachycardia (postural tachycardia syndrome) and without (hypocapnic cerebral hypoperfusion) represent a spectrum of the same disorder.Frontiers in neurology · 2024Article
- Network autonomic analysis of post-acute sequelae of COVID-19 and postural tachycardia syndrome.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022Article
- Heart-brain synchronization breakdown in Parkinson's disease.NPJ Parkinson's disease · 2022Article
- Test-retest reliability of the Valsalva maneuver in spinal cord injury.The journal of spinal cord medicine · 2022Article
- Multisystem Involvement in Post-Acute Sequelae of Coronavirus Disease 19.Annals of neurology · 2022Article
- Effects of Oral Leak Size on Valsalva Responses.Journal of community hospital internal medicine perspectives · 2022Article
- Do indices of baroreflex failure and peripheral noradrenergic deficiency predict the magnitude of orthostatic hypotension in Lewy body diseases?Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2021Article
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Authors and funding
1 author.
Funding
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Abstract
objectiveBlood pressure (BP) decline and recovery during the Valsalva maneuver (VM) are used to evaluate the degree of sympathetic failure (SF) but a reliable sympathetic index (SI) derived from VM is lacking.
methodsPatients with mild (n=20), moderate (n=65), and severe (n=60) SF and 23 healthy controls were evaluated using a standardized battery of autonomic tests. SF was defined as mild (associated with reduced sudomotor volumes at distal leg); moderate (associated with a fall in systolic BP ≥10< 30 mm Hg during the tilt test); and severe (associated with a fall in systolic BP ≥30 mm Hg during the tilt test). Six SIs were compared: SI1 (BP fall during phase 2), SI2 (BP recovery during phase 2), SI3 (the difference in BP between baseline and the end of phase 2), SI4 (the magnitude of phase 4), SI5 (BP recovery time), and SI6 (baroreflex sensitivity index).
resultsAll indexes showed overall significant differences among tested groups (p<0.05). Only SI3 differentiated all subject groups. Compared to other SIs, SI3 correlated the most with orthostatic hypotension (OH; r=0.62, p < 0.05) during the tilt.
conclusionsSI3 is the optimal method for calculation of SI since it 1) easily differentiates between healthy controls and those with SF; 2) correlates with the OH, a proxy for a sympathetic failure; 3) tracks the full spectrum of SF (mild-moderate-severe). SI3 expands the utility of quantitative autonomic testing.
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