Valsalva Maneuver is an integral part of the Ewing battery of tests used for the evaluation of cardiac autonomic neuropathy.[8] Valsalva ratio, the ratio of the longest inter-beat (RR) interval after the expiratory strain and the shortest inter-beat interval during the strain, is an index of parasympathetic function. Also, determination of baroreflex sensitivity (BRS) can be performed using the Valsalva maneuver to assess the integrity of the baroreflex by estimating the slope of a regression plot between RR intervals and systolic blood pressure values during phases II and IV of the maneuver
