Ping Wang1, Sha-Sha Chen2,3, Ying Li2,3, Xiao-Yong Zhang2,3. 1. Department of Ultrasound Medicine, The First People' Hospital of Xianyang City, Xianyang, China. 2. The First Affiliated Hospital of Xi'an Medical College, Xi'an, China. 3. School of General Medicine of Xi'an Medical College, Xi'an, China.
Abstract
AIM: To explore the value of cough maneuver (CM) in detecting right-to-left (RLS) during contrast transthoracic echocardiography (cTTE) and its mechanism. METHOD: We enrolled 196 patients with a high level of clinical suspicion of RLS underwent cTTE for RLS detection. Valsalva maneuver (VM) (blowing into a face mask connected to a sphygmomanometer at 40 mm Hg for 10 seconds) and CM were performed to provoke RLS, respectively. A comparison of the two provocative maneuvers in terms of the RLS-detection rate, the degree of RLS, the mobility of septum primum was done. RESULTS: The detection rates of RLS for CM were significantly higher than that for VM (38.3% vs 32.1%), (P < 0.001). There was no significant difference between VM and CM in terms of detecting moderate- or severe-extent RLS (P > 0.05), however, CM was significantly better than VM in detecting mild-extent RLS (P = 0.004). CM caused a greater mobility of septum primum than VM (20.1 ± 0.2 mm vs 6.3 ± 0.1 mm), (P < 0.001). CONCLUSION: Cough maneuver had a higher detection rate for RLS than VM during cTTE, maybe due to its greater mobility of septum primum than VM caused.
AIM: To explore the value of cough maneuver (CM) in detecting right-to-left (RLS) during contrast transthoracic echocardiography (cTTE) and its mechanism. METHOD: We enrolled 196 patients with a high level of clinical suspicion of RLS underwent cTTE for RLS detection. Valsalva maneuver (VM) (blowing into a face mask connected to a sphygmomanometer at 40 mm Hg for 10 seconds) and CM were performed to provoke RLS, respectively. A comparison of the two provocative maneuvers in terms of the RLS-detection rate, the degree of RLS, the mobility of septum primum was done. RESULTS: The detection rates of RLS for CM were significantly higher than that for VM (38.3% vs 32.1%), (P < 0.001). There was no significant difference between VM and CM in terms of detecting moderate- or severe-extent RLS (P > 0.05), however, CM was significantly better than VM in detecting mild-extent RLS (P = 0.004). CM caused a greater mobility of septum primum than VM (20.1 ± 0.2 mm vs 6.3 ± 0.1 mm), (P < 0.001). CONCLUSION:Cough maneuver had a higher detection rate for RLS than VM during cTTE, maybe due to its greater mobility of septum primum than VM caused.