{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:54:46Z","timestamp":1792029286501,"version":"4.4.0"},"reference-count":34,"publisher":"American Physiological Society","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American Journal of Physiology-Regulatory, Integrative and Comparative Physiology"],"published-print":{"date-parts":[[2016,2,1]]},"abstract":"<jats:p> The objective of this study was to assess hemodynamic responses and baroreflex sensitivity (BRS) indexes during Valsalva maneuver (VM) and head-up tilt (HUT) testing in orthostatic intolerance (OI). Patients with neurogenic orthostatic hypotension (NOH, n = 26), postural tachycardia syndrome ( n = 26) and symptomatic OI ( n = 14) were compared with healthy population (control, n = 107) and inappropriate sinus tachycardia ( n = 7). Hemodynamic assessment included patterning and quantification with vagal and adrenergic BRS (BRSa\/BRSa<jats:sub>1<\/jats:sub>). In NOH, cardiovagal systolic blood pressure (SBP) decrements in VM and HUT were correlated ( r = 0.660, P &lt; 0.001); a \u201cV\u201d pattern of VM indicated \u03b1-BRSa failure. Yet BRSa<jats:sub>1<\/jats:sub> did not reveal changes vs. control ( P &gt; 0.05) or was not applicable in 60% of NOH. In symptomatic OI, compared with control, cardiovagal SBP decrements were larger ( P &lt; 0.05); higher BRSa<jats:sub>1<\/jats:sub> contradicted higher adrenergic index (Composite Autonomic Severity Score). Overshoot in phase IV dipped below baseline or dropped \u2265 10 mmHg over 8 s in postural tachycardia syndrome (\u201cN\u201d pattern), but by 3 s in inappropriate sinus tachycardia (\u201cM\u201d pattern). Visualization of distinct VM patterns allows primary evaluation of autonomic dysfunction and differentiation of the various forms of OI. BRSa<jats:sub>1<\/jats:sub> evaluation is compromised by pathological SBP patterns. VM patterning is a valuable nonpostural supplement to HUT capable of detecting and differentiating OI. <\/jats:p>","DOI":"10.1152\/ajpregu.00290.2015","type":"journal-article","created":{"date-parts":[[2015,10,21]],"date-time":"2015-10-21T23:29:56Z","timestamp":1445470196000},"page":"R243-R252","source":"Crossref","is-referenced-by-count":21,"title":["The utility of Valsalva maneuver in the diagnoses of orthostatic disorders"],"prefix":"10.1152","volume":"310","author":[{"given":"Iryna S.","family":"Palamarchuk","sequence":"first","affiliation":[{"name":"Department of Clinical Neurological Sciences, University Hospital, London Health Sciences Centre, London, Ontario, Canada; and"},{"name":"Schulich School of Medicine &amp; Dentistry, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacquie","family":"Baker","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurological Sciences, University Hospital, London Health Sciences Centre, London, Ontario, Canada; 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