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. 2015 Jul 23:13:33.
doi: 10.1186/s12947-015-0024-5.

Early markers of right heart involvement in regular smokers by Pocket Size Imaging Device

Vincenzo Schiano-Lomoriello  1   2 , Roberta Esposito  1   2 , Ciro Santoro  1   2 , Giovanni de Simone  1   2 , Maurizio Galderisi  3   4
Affiliations

Early markers of right heart involvement in regular smokers by Pocket Size Imaging Device

Vincenzo Schiano-Lomoriello et al. Cardiovasc Ultrasound. .

Abstract

Purpose: 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.

Methods: 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.

Results: 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.

Conclusions: PSID detects early ultrasound signs of RH involvement in regular otherwise healthy smokers in comparison with PE.

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Figures

Fig. 1
Fig. 1
Head to head comparison of the rate of regular smokers with at least one abnormality in simplified Boston score and PSID score. PSID additional diagnostic power appears to be of 44.9 %
Fig. 2
Fig. 2
IVC and RA size of regular smokers according to tertiles of cigarettes smoked per day. RA = Right atrial, IVC = Inferior vena cava
See this image and copyright information in PMC

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