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Research ArticleOriginal Research

Value of Plethysmographic Pulse Amplitude Ratio With Valsalva Maneuver in Identifying Left Ventricular Dysfunction During COPD Exacerbation

Hamdi Boubaker, Mohamed Habib Grissa, Haithem Debbabi, Kaouthar Beltaief, Zohra Dridi, Mohamed Fadhel Najjar, Wahid Bouida, Riadh Boukef, Soudani Marghli and Semir Nouira
Respiratory Care April 2016, 61 (4) 439-446; DOI: https://doi.org/10.4187/respcare.04091
Hamdi Boubaker
Emergency Department, Fattouma Bourguiba University Hospital Monastir, Tunisia and the Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.
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Mohamed Habib Grissa
Emergency Department, Fattouma Bourguiba University Hospital Monastir, Tunisia and the Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.
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Haithem Debbabi
Emergency Department, Fattouma Bourguiba University Hospital Monastir, Tunisia and the Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.
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Kaouthar Beltaief
Emergency Department, Fattouma Bourguiba University Hospital Monastir, Tunisia and the Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.
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Zohra Dridi
Cardiology Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia.
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Mohamed Fadhel Najjar
Biochemistry Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia.
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Wahid Bouida
Emergency Department, Fattouma Bourguiba University Hospital Monastir, Tunisia and the Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.
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Riadh Boukef
Emergency Department, Sahloul University Hospital, Sousse, Tunisia and the Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.
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Soudani Marghli
Emergency Department, Tahar Sfar University Hospital, Mahdia, Tunisia and the Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.
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Semir Nouira
Emergency Department, Fattouma Bourguiba University Hospital Monastir, Tunisia and the Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.
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  • For correspondence: [email protected]
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    Fig. 1.

    Pulse amplitude ratio using plethysmographic waveform recording under the Valsalva maneuver in a subject with COPD exacerbation associated with ventricular dysfunction. Plethysmographic pulse amplitude ratio = minimum plethysmographic pulse amplitude (PPAmin)/maximum plethysmographic pulse amplitude (PPAmax). In the example of this figure, the plethysmographic pulse amplitude ratio = 0.60.

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    Fig. 2.

    Box plots showing plethysmographic pulse amplitude ratio (plethPAR) in the 3 study groups: acute heart failure group, subjects with COPD exacerbation and left ventricular dysfunction (COPD exacerbation with LVD), and subjects with COPD exacerbation without left ventricular dysfunction (COPD exacerbation without LVD). The line in each box indicates the median. The upper and lower limits of each box indicate the 75th and 25th percentiles, respectively. Whiskers denote the 90th and 10th percentiles. *, P < .05 vs acute heart failure and COPD exacerbation with left-ventricular dysfunction groups.

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    Fig. 3.

    Correlation between plethysmographic pulse amplitude ratio (plethPAR) and brain natriuretic peptide in subjects with COPD exacerbation. The regression line and correlation coefficient are shown.

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    Fig. 4.

    Receiver operating characteristic curves for the diagnosis of left ventricular dysfunction related to plethysmographic pulse amplitude ratio (plethPAR) and to Boston score. Area under the curve was 0.92 (95% CI 0.87–0.97) and 0.76 (95 CI 0.66–0.85), respectively, for the plethysmographic pulse amplitude ratio and Boston score.

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Respiratory Care: 61 (4)
Respiratory Care
Vol. 61, Issue 4
1 Apr 2016
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Value of Plethysmographic Pulse Amplitude Ratio With Valsalva Maneuver in Identifying Left Ventricular Dysfunction During COPD Exacerbation
Hamdi Boubaker, Mohamed Habib Grissa, Haithem Debbabi, Kaouthar Beltaief, Zohra Dridi, Mohamed Fadhel Najjar, Wahid Bouida, Riadh Boukef, Soudani Marghli, Semir Nouira
Respiratory Care Apr 2016, 61 (4) 439-446; DOI: 10.4187/respcare.04091

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Value of Plethysmographic Pulse Amplitude Ratio With Valsalva Maneuver in Identifying Left Ventricular Dysfunction During COPD Exacerbation
Hamdi Boubaker, Mohamed Habib Grissa, Haithem Debbabi, Kaouthar Beltaief, Zohra Dridi, Mohamed Fadhel Najjar, Wahid Bouida, Riadh Boukef, Soudani Marghli, Semir Nouira
Respiratory Care Apr 2016, 61 (4) 439-446; DOI: 10.4187/respcare.04091
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Keywords

  • COPD
  • Valsalva maneuver
  • heart failure
  • left ventricular dysfunction
  • plethysmography

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