Schiano-Lomoriello Vincenzo, Esposito Roberta, Santoro Ciro, de Simone Giovanni, Galderisi Maurizio
Hypertension Research Center (CIRIAPA), Federico II University Hospital, Naples, Italy.
Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy.
Cardiovasc Ultrasound. 2015 Jul 23;13:33. doi: 10.1186/s12947-015-0024-5.
To test the diagnostic power of Pocket Size Imaging Device (PSID) in detecting early signs of right heart (RH) involvement in regular smokers (RS) free of overt cardiac involvement.
One-hundred-forty-three regular smokers and 51 healthy controls, comparable for age and sex, underwent physical exam (PE), PSID exam and standard echocardiography. Based on a simplified Boston score, ≥1 of clinical signs (jugular venous distension, hepatomegaly, peripheral pitting oedema and abnormal pulmonary sounds) were considered indicative of RH involvement. A composite score (1 to 4) obtained by summing the points of four quantitative RH abnormalities detectable by PSID (inferior vena cava [IVC] dilatation, reduced IVC respiratory variation, right ventricular dilatation and right atrial dilatation), was generated and ≥1 of PSID abnormal signs was considered indicative of RH involvement.
Boston score was not significantly different between the two groups. By using PSID, smokers exhibited greater IVC diameter (p < 0.0001), right atrial diameter (p < 0.002) and higher PSID score (p < 0.005) than controls. Compared to PE, the additional diagnostic power of PSID (≥1 abnormal sign of both Boston and PSID score) was 44.9% in smokers. By dividing smokers in tertiles according to number of cigarettes per day, the third tertile showed the largest values of both IVC and right atrial dimension. Differences were confirmed by standard echocardiography. Reproducibility of PSID measurements and concordance of linear measurements between PSID and standard echo measurements was very good except for concordance of right ventricular basal diameter.
PSID detects early ultrasound signs of RH involvement in regular otherwise healthy smokers in comparison with PE.
测试袖珍成像设备（PSID）在检测无明显心脏受累的规律吸烟者（RS）右心（RH）受累早期迹象方面的诊断能力。
143名规律吸烟者和51名年龄和性别匹配的健康对照者接受了体格检查（PE）、PSID检查和标准超声心动图检查。根据简化的波士顿评分，临床体征（颈静脉扩张、肝肿大、外周凹陷性水肿和异常肺部啰音）中≥1项被认为提示RH受累。通过将PSID可检测到的四项定量RH异常（下腔静脉[IVC]扩张、IVC呼吸变化减小、右心室扩张和右心房扩张）的分数相加得到一个综合评分（1至4分），PSID异常体征中≥1项被认为提示RH受累。
两组之间的波士顿评分无显著差异。使用PSID时，吸烟者的IVC直径（p<0.0001）、右心房直径（p<0.002）和PSID评分更高（p<0.005）。与PE相比，PSID（波士顿和PSID评分均≥1项异常体征）在吸烟者中的额外诊断能力为44.9%。根据每日吸烟量将吸烟者分为三分位数，第三三分位数的IVC和右心房尺寸值最大。标准超声心动图证实了差异。PSID测量的可重复性以及PSID与标准回声测量之间线性测量的一致性非常好，除了右心室基底直径的一致性。
与PE相比，PSID可检测到无其他明显疾病的规律吸烟者RH受累的早期超声迹象。
