title: Early markers of right heart involvement in regular smokers by Pocket Size Imaging Device.
abstract: OBJECTIVE
  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.
authors.affiliation: Hypertension Research Center (CIRIAPA), Federico II University Hospital, Naples, Italy.|Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Schiano-Lomoriello
authors.affiliation: Hypertension Research Center (CIRIAPA), Federico II University Hospital, Naples, Italy.|Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Esposito
authors.affiliation: Hypertension Research Center (CIRIAPA), Federico II University Hospital, Naples, Italy.|Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy.
authors.forename: Ciro
authors.initials: C
authors.lastname: Santoro
authors.affiliation: Hypertension Research Center (CIRIAPA), Federico II University Hospital, Naples, Italy.|Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Simone
authors.affiliation: Hypertension Research Center (CIRIAPA), Federico II University Hospital, Naples, Italy. mgalderi@unina.it.|Department of Advanced Biomedical Sciences, Federico II University Hospital, Via S. Pansini 5,bld 1, Naples, 80131, Italy. mgalderi@unina.it.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Galderisi
mesh_terms: D015415:Biomarkers; D004452:Echocardiography / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008904:Miniaturization; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012907:Smoking / Q000009:adverse effects* / Q000503:physiopathology*; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000209:etiology*
chemical_list: D015415:Biomarkers