Abstract
Background: There is little knowledge of RV remodeling in IPF without PH.
Aim: To elucidate RV remodeling in IPF with or without PH.
Methods and Results: Clinical evaluation, transthoracic Echo-Color-Doppler Myocardial Imaging (DMI) and 2D X-strain echocardiography (2DSE) were performed in 52 IPF patients (mean age: 66.5± 8.5 years; range 42 – 80; 27 males) and in 45 age and sex-matched controls.The IPF pts were divided into 2 groups by non-invasive Doppler assessment of mean pressure (mPAP): mPAP <25 mm Hg, 36 pts vs mPAP≥25mmHg, 16 pts. Left ventricular (LV) diameters and ejection fraction were within normal limits and there was no significant difference between controls and IPF. RV end-diastolic diameters and wall thickness were mildly increased in IPF pts with PH. Tricuspid inflow E/A ratio was decreased in IPF with PH. In addition, pulsed DMI detected in PH-IPF impaired myocardial RV early-diastolic (Em) peak velocity and comparable systolic velocity at tricuspid annulus level. In IPF, peak systolic RV X-strain was reduced in basal and middle RV lateral free walls (p<0.0001). The impairment in RV wall strain was more evident when comparing controls with the no PH group than comparing the no PH group with the PH group. By multivariate analysis, independent association of RV lateral wall X-strain with both 6MWD (p<0.001), mPAP (p<0.0001) and FVC % (p<0.005) in IPF pts were observed.
Conclusions: Impaired RV diastolic and systolic myocardial function were present even in IPF pts without PH, which suggests an early impact on RV remodeling.
- Copyright ©ERS 2015
