[Relationship between Hoover sign, functional and variables, and curvature radius in patients with obstructive pulmonary disease].
The purpose of the present study was: 1) to relate the Hoover sign -SH (+)- with several functional (spirometry and lung volumes) and radiographic (AP x-ray) parameters, 2) to characterize the changes in diaphragmatic curvature radius and the efficiency and to establish some relationships with the functional and radiographic parameters. Fifteen patients with COPD (SH (+), n: 8) were studied. The radius was determined in the right hemidiaphragm after maximal inspired and expired x-ray. The SH (+) was found in more severely obstructed patients (FEV1%, p 0.005%) and with high degree of air trapping (RV/TLC %, p 0.01). The expiratory radius (Re) was higher (p 0.05), and their efficiency (1/Re), was minor (p 0.05). The FEV1% correlated with the degree of hyperinflation according to TLC % (r -0.58, p 0.022) and with air trapping according to RV % (r -0.77, p 0.0008). The patients with low FEV1% showed high Re (r -0.61, p 0.015) and decreased diaphragmatic efficiency during expiration (1/Re) according to 1/Re = 0.093 cm-1 + 0.0012 cm-1* FEV1% (r 0.688, p 0.0054). The FEV1 correlated with the diaphragmatic movement (r 0.71, p 0.003). The PaCO2 correlated with the TLC % (r 0.534, p 0.04), the RV% (r 0.62, p 0.014) and with the radiographic parameters of hyperinflation (r 0.546, p 0.035) and air trapping (r 0.528, p 0.043). The presence of Hoover sign suggest severe bronchial obstruction, diaphragmatic flattening, increase of curvature radius, decrease of mobility and efficiency.
Capria
María E
ME
Instituto de Investigaciones Médicas Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires.
D' Negri
Carlos
C
De Vito
Eduardo L
EL
De Negri
Carlos
C
D000368:Aged; D015992:Body Mass Index; D003964:Diaphragm / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008176:Lung Volume Measurements; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011859:Radiography; D012129:Respiratory Function Tests; D012135:Respiratory Sounds; D013147:Spirometry; D018709:Statistics, Nonparametric; D014797:Vital Capacity