title: Modeling Pathological Hemodynamic Responses to the Valsalva Maneuver.
abstract: The Valsalva maneuver (VM) 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 (BP) and heart rate (HR) 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 BP and HR 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 with a clear physiological meaning. The simulation results confirm the adaptability of our model and its usefulness for diagnostic or educational purposes.
authors.affiliation: Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Ks. Trojdena 4, Warsaw 02-109, Poland e-mail: leszek.pstras@ibib.waw.pl.
authors.forename: Leszek
authors.initials: L
authors.lastname: Pstras
authors.affiliation: Institute of Electronics, Computer and Telecommunication Engineering, National Research Council, c/o University of Padova (DEI), Via G. Gradenigo 6/b, Padova 35131, Italy e-mail: karl.thomaseth@ieiit.cnr.it.
authors.forename: Karl
authors.initials: K
authors.lastname: Thomaseth
authors.affiliation: Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Ks. Trojdena 4, Warsaw 02-109, Poland e-mail: jacek.waniewski@ibib.waw.pl.
authors.forename: Jacek
authors.initials: J
authors.lastname: Waniewski
authors.affiliation: Department of Medicine, Sant'Antonio Hospital, Via Jacopo Facciolati 71, Padova 35127, Italy e-mail: italo.balzani@sanita.padova.it.
authors.forename: Italo
authors.initials: I
authors.lastname: Balzani
authors.affiliation: Rizzola Foundation Hospital, Via Gorizia 1, San Donà di Piave (Venezia) 30027, Italy e-mail: bellavere@rizzola.it.
authors.forename: Federico
authors.initials: F
authors.lastname: Bellavere
mesh_terms: D062186:Arterial Pressure; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology; D006439:Hemodynamics; D008955:Models, Cardiovascular; D013318:Stroke Volume; D014636:Valsalva Maneuver