RT Journal Article T1 Influence of repetitions on the Valsalva maneuver A1 Saldaña García, Jesús A1 Torremocha López, Ana A1 Dawid-Milner, Marc Stefan K1 Respiración - Técnica AB Objective: In autonomic units, patients perform several short Valsalva maneuvers (VMs) while learning the procedure. The effects of repeated VMs on cardiovascular elicited responses were assessed.Methods: 14 healthy volunteer subjects were selected (aged 22-26). VMs were performed every 3 min up to 6 times in a reclined sitting position. Changes in blood pressure (BP), heart rate (HR) and baroreflex sensitivity indexes were evaluated. Subjects were classified according to their adrenergic response patterns.Results: VMs repetitions evoked a progressive decrease in BP during phases II and III and a reduced increase in mean BP at late phase II. Increased bradycardia at early phase II and IV was also observed. Last two VMs showed a significant increase in Valsalva ratio, while other indexes remained unaltered. Subjects with balanced adrenergic responses presented extended pressure recovery time from the third repetition and lower BP values than those with augmented or suppressed adrenergic responses.Conclusions: Significant changes in BP and HR at certain phases were observed when consecutive VMs were performed in young subjects in a reclined position. The most affected baroreflex index was the Valsalva ratio. Adrenergic response patterns showed differences that should be considered in order to avoid false positives.Significance: We recommend not repeating the VM more than 4 times and revisiting the role and reliability of the Valsalva ratio. PB Elsevier YR 2020 FD 2020-05-15 LK https://hdl.handle.net/10630/36380 UL https://hdl.handle.net/10630/36380 LA eng NO Saldaña García J, Torremocha López A, Dawid Milner MS. Influence of repetitions on the Valsalva maneuver. Clin Neurophysiol Pract. 2020 May 15;5:104-111. doi: 10.1016/j.cnp.2020.04.003. PMID: 32518858; PMCID: PMC7272514. NO The study was supported by a program grant Junta de Andalucía, Grupo Consolidado no. CTS156, Spain. DS RIUMA. Repositorio Institucional de la Universidad de Málaga RD 19 ene 2026