RT Journal Article
SR Electronic
T1 Predictors of esophageal dilatation in patients with idiopathic pulmonary fibrosis
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2364
VO 42
IS Suppl 57
A1 Harpavan Sandha
A1 Vimal Ponnezhan
A1 Andrea Lu
A1 Christopher Lee
A1 Alex Balekian
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P2364.abstract
AB Background: Gastroesophageal reflux (GER) has been considered as a cause of idiopathic pulmonary fibrosis (IPF), but an exact relationship is unclear. Because the increased elastic recoil of fibrotic lungs can transmit negative intrathoracic pressures to the esophagus, we aimed to examine factors associated with esophageal dilatation in IPF patients.Methods: Retrospective cross-sectional review at a private and public hospital. Subjects had a classic usual interstitial pneumonitis pattern on computed tomography (CT) scan, no serologic evidence of connective tissue disease, and no other associated causes of interstitial lung disease. We performed logistic regression on the presence of esophageal dilatation on CT using pulmonary function test (PFT) results within three months of the scan, as well as demographic factors.Results: The 30 subjects were predominantly male (73%), Hispanic (63%), and from a private hospital setting (73%). Mean PFT results for FEV1, forced vital capacity, and diffusion of carbon monoxide (DLCO) were 75, 64, and 39 percent of predicted, respectively. 14 patients (47%) had esophageal dilatation on CT. Factors associated with esophageal dilatation included male sex (odds ratio [OR] 7.93, p=0.07), lower DLCO (OR 2.18 per 10-percent decrease, p=0.06), and public hospital setting (OR 16.95, p=0.06).Discussion: Lower DLCO and male sex are associated with esophageal dilatation on CT scans of IPF patients, and patient-specific factors at a public hospital (race, socioeconomic status, education) might play a role as well. These risk factors might prompt clinicians to search for esophageal dilatation and resultant GER that might accelerate the progression of IPF.