Abstract

CAPRIA, M. E.; D'NEGRI, C.  and  DE VITO, E. L.. Analisis del signo de Hoover en relacion con  parametros funcionales, radiologicos  y de radio de curvatura en pacientes con enfermedad pulmonar obstructiva cronica. Medicina (B. Aires) [online]. 2003, vol.63, n.5, pp.369-376. ISSN 0025-7680.

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.

Keywords : COPD; Hoover´s sign; Diaphragm; Curvature radius; Diafragmatic efficiency; Hyperinflation.

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