Heart failure & cardiomyopathies
Self- and Goal-Directed Valsalva Maneuver vs Exercise in Eliciting Left Ventricular Outflow Tract Obstruction
Authors' conclusion
While GDV is superior to SDV, post-EX stress echo remains the gold standard in evaluating symptomatic patients with clinical concern for obstructive physiology.
Study context
- Population
- Patients with hypertrophic cardiomyopathy (HCM) or suspicion for obstructive physiologypatients included
- Participants
- 59 patients
- Exposure
- compare the efficacy of exercise (EX), goal-directed Valsalva (GDV), and self-directed Valsalva (SDV) in eliciting left ventricular outflow tract obstruction (LVOTO) in patients
Methodological detailssame-day
- Same-day
Main finding
As reported in the abstract
Mean peak LVOT gradient
P < 0.01
Observational data: associations, not effects.
Further findings
| Outcome | EX | GDV | SDV | P value | |
|---|---|---|---|---|---|
| Reclassification to obstructive physiology · more patients reclassified with EX | 25% | Not reported in the abstract | 8% | P < 0.05 | GDV: not reported in the abstract |
| Reclassification to severe obstructive HCM · more patients reclassified with EX | 15% | 8% | Not reported in the abstract | P < 0.05 | SDV: not reported in the abstract |
Baseline characteristics
- Mean age
- 55 years
- Men
- 55%
- Average wall thickness
- 17 mm
Original publication
Self- and Goal-Directed Valsalva Maneuver vs Exercise in Eliciting Left Ventricular Outflow Tract Obstruction. JACC Adv. Published 20 January 2026. doi:10.
Summarised from the published abstract; every number is checked against it