1. Right Ventricular Functional Reserve in Early-Stage Idiopathic Pulmonary Fibrosis
- Author
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Antonello D’Andrea, Anna Agnese Stanziola, Rajan Saggar, Rajeev Saggar, Simona Sperlongano, Marianna Conte, Michele D’Alto, Francesco Ferrara, Luna Gargani, Patrizio Lancellotti, Eduardo Bossone, Robert Naeije, William F. Armstrong, Theodore John Kolias, Luigi Caliendo, Rosangela Cocchia, Rodolfo Citro, Michele Bellino, Ilaria Radano, Antonio Cittadini, Paola Argiento, Andreina Carbone, Santo Dellegrottaglie, Nicola De Luca, Montuori Maria Grazia, Francesco Rozza, Valentina Russo, Giovanni Di Salvo, Stefano Ghio, Ekkerard Grunig, Alberto Marra, Marco Guazzi, Francesco Bandera, Valentina Labate, André La Gerche, Giuseppe Limongelli, Giuseppe Pacileo, Marina Verrengia, Jaroslaw D. Kasprzak, Karina Wierzbowska Drabik, Gabor Kovacs, Antonella Moreo, Francesca Casadei, Benedetta De Chiara, Ellen Ostenfeld, Francesco Pieri, Lorenza Pratali, Christine Selton-Suty, Olivier Huttin, Clément Venner, Walter Serra, Anna Stanziola, Maria Martino, Giovanna Caccavo, István Szabó, Albert Varga, Gergely Agoston, Darmien Voilliot, Olga Vriz, Domenico Galzerano, Marco Scalese, and Luca Carannante
- Subjects
Pulmonary and Respiratory Medicine ,Spirometry ,medicine.medical_specialty ,Speckle tracking echocardiography ,Doppler echocardiography ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,Idiopathic pulmonary fibrosis ,0302 clinical medicine ,Internal medicine ,medicine ,Stress Echocardiography ,030212 general & internal medicine ,Pulmonary wedge pressure ,medicine.diagnostic_test ,business.industry ,respiratory system ,medicine.disease ,Pulmonary hypertension ,respiratory tract diseases ,medicine.anatomical_structure ,030228 respiratory system ,Vascular resistance ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background The most important determinant of long-term survival in patients with idiopathic pulmonary fibrosis is the right ventricular (RV) adaptation to the increased pulmonary vascular resistance. Our aim was to explore RV contractile reserve during stress echocardiography in early-stage IPF. Methods Fifty early-stage patients with IPF and 50 healthy control patients underwent rest and stress echocardiography, including RV two-dimensional speckle tracking echocardiography. At peak exertion, blood gas analysis and spirometry were also assessed. Results At rest, RV diameters were mildly increased in IPF; however, although RV conventional systolic function indexes were similar between the IPF and control groups, RV global longitudinal strain and RV lateral wall longitudinal strain (LWLS) were significantly reduced in the IPF cohort. During physical exercise, patients with IPF showed a reduced exercise tolerance with lower maximal workload (P o 2; P Conclusions RV myocardial dysfunction is already present at rest in early-stage IPF and worsens during exertion as detected by two-dimensional speckle-tracking echocardiography. The RV altered contractile reserve appears to be related to reduced exercise tolerability and impaired pulmonary hemodynamic.
- Published
- 2019
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