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Is inferior vena cava compression an alternative for valsalva maneuver in contrast‐enhanced transcranial doppler？
Author(s) -
He Yitao,
Deng Jian,
Tu Jingmei,
Zhang Hui,
Guo Yi
Publication year - 2020
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14550
Subject(s) - transcranial doppler , medicine , valsalva maneuver , inferior vena cava , right to left shunt , cardiology , migraine , patent foramen ovale , blood pressure
Objectives To evaluate whether inferior vena cava compression (IVCC) can be an alternative for valsalva maneuver (VM) in contrast‐enhanced transcranial doppler (c‐TCD). Methods Patients diagnosed with ischemic stroke, transient ischemic attack, and migraine were enrolled in this study. C‐TCD was conducted at resting state, after VM and IVCC to detect right to left shunt (RLS). Then, the RLS was compared to examine whether IVCC could be an alternative for VM in c‐TCD. Results A total of 246 patients were enrolled in this study. Via Wilcoxon signed‐rank test of paired data, the detection for RLS of c‐TCD conducted after IVCC was superior to at resting state, but inferior to after VM ( P .001, P = .01, respectively); the detection for RLS of c‐TCD conducted after IVCC was inferior to after VM for patients with good cooperation of VM, but was superior for patients with poor cooperation of VM ( P .001, P .001, respectively); the detection for RLS of c‐TCD conducted after IVCC and after VM showed no significant difference for patients with good cooperation of VM and without abdominal obesity, or with poor cooperation of VM and with abdominal obesity ( P = .201, P = .157, respectively); the detection for RLS of c‐TCD conducted after IVCC was superior to at resting state for patients with abdominal obesity ( P .001). Conclusions For patients with poor cooperation of VM, IVCC could be used as an effective supplement to increase the detection of RLS in c‐TCD.