• CobraSandra de BarrosSde BHospital de Base do Distrito Federal, Brasília, Federal District, Brazil., Rayane Marques Cardoso, and Marcelo Palmeira Rodrigues.
• Hospital de Base do Distrito Federal, Brasília, Federal District, Brazil.
• Sao Paulo Med J. 2016 Jan 1; 134 (1): 343934-9.

Context And ObjectiveP2 hyperphonesis is considered to be a valuable finding in semiological diagnoses of pulmonary hypertension (PH). The aim here was to evaluate the accuracy of the pulmonary component of second heart sounds for predicting PH in patients with interstitial lung disease.Design And SettingCross-sectional study at the University of Brasilia and Hospital de Base do Distrito Federal.MethodsHeart sounds were acquired using an electronic stethoscope and were analyzed using phonocardiography. Clinical signs suggestive of PH, such as second heart sound (S2) in pulmonary area louder than in aortic area; P2 > A2 in pulmonary area and P2 present in mitral area, were compared with Doppler echocardiographic parameters suggestive of PH. Sensitivity (S), specificity (Sp) and positive (LR+) and negative (LR-) likelihood ratios were evaluated.ResultsThere was no significant correlation between S2 or P2 amplitude and PASP (pulmonary artery systolic pressure) (P = 0.185 and 0.115; P= 0.13 and 0.34, respectively). Higher S2 in pulmonary area than in aortic area, compared with all the criteria suggestive of PH, showed S = 60%, Sp= 22%; LR+ = 0.7; LR- = 1.7; while P2> A2 showed S= 57%, Sp = 39%; LR+ = 0.9; LR- = 1.1; and P2 in mitral area showed: S= 68%, Sp = 41%; LR+ = 1.1; LR- = 0.7. All these signals together showed: S= 50%, Sp = 56%.ConclusionsThe semiological signs indicative of PH presented low sensitivity and specificity levels for clinically diagnosing this comorbidity.

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