Abnormal hemodynamic response to valsalva maneuver in mitral stenosis

Acute hemodynamic response to the Valsalva maneuver has long been used as a means of assessing the circulatory changes in various cardiovascular diseases.^1-5 An abnormal Valsalva response regarding blood pressure and heart rate changes has been reported in patients with mitral stenosis (MS).^4-6 However, the central blood flow changes were not determined previously, and hence the potential effects of cardiac stroke output during this maneuver are poorly understood. Recently, Doppler echocardiography proved to be a useful noninvasive method to evaluate left ventricular stroke output.^7,9 The purpose of the present study was to evaluate the effect of the Valsalva maneuver on aortic blood flow profiles in patients with MS using the Doppler echocardiographic technique, and to better understand the extent and mechanism of abnormal hemodynamic response to this maneuver in MS based on the beat-to-beat estimation.