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Published online before print December 5, 2007
Eur Respir J 2007, doi:10.1183/09031936.00102107
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ORIGINAL ARTICLE

Left ventricular diastolic dysfunction in idiopathic pulmonary fibrosis: A tissue-Doppler echocardiographic study

C.E. Papadopoulos 1, G. Pitsiou 2, T.D. Karamitsos 1, H.I. Karvounis 1, T. Kontakiotis 2, G. Giannakoulas 1, G.K. Efthimiadis 1, P. Argiropoulou 2, G.E. Parharidis 1, D. Bouros 3*

1 1st Cardiology Dept, AHEPA University Hospital, Thessaloniki, Greece
2 Respiratory Failure Unit, Aristotle University of Thessaloniki, Greece
3 Dept of Pneumonology, Medical School University of Thrace, Alexandroupolis 68100, Greece

* To whom correspondence should be addressed. E-mail: bouros{at}med.duth.gr.


  Abstract

We hypothesised that apart from right ventricular (RV) dysfunction, patients with idiopathic pulmonary fibrosis (IPF) also exhibit left ventricular (LV) impairment, which may affect disease progression and prognosis.

To evaluate LV performance in a cohort of IPF patients using conventional and tissue Doppler echocardiography.

We studied 22 IPF patients (mean age 65±9 years) exhibiting mild to moderate pulmonary artery hypertension and 22 healthy individuals (mean age 61±6 years). We used conventional and tissue Doppler echocardiography for the evaluation of RV and LV systolic and diastolic function.

Apart from the expected impairment in RV function, all patients showed a characteristic reversal of LV diastolic filling to late diastole compared to controls (E/A 0.7±0.2 vs. 1.5±0.1 respectively, p<0.001). Patients with IPF also exhibited lower peak myocardial velocities in early diastole (Em 5.7±1.1 vs. 10.3±1.6 respectively, p<0.001), higher in late diastole (Am 8.9±1.3 vs.5.5±0.8 respectively, p<0.001), lower Em/Am (0.6±0.1 vs.1.9±0.5 respectively, p<0.001) and higher E/Em ratio (10.8±3 vs. 6±0.6 respectively, p<0.001), all indicative of LV diastolic dysfunction. Moreover, LV propagation velocity was significantly lower in IPF patients (46±13 vs. 83±21 respectively, p<0.001).

Physicians should be aware that patients with IPF exhibit early impairment of LV diastolic function.

Keywords:  Diastole, Doppler echocardiography, Idiopathic pulmonary fibrosis, left ventricular dysfunction




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