Buonauro, Agostino (2020) Impaired right and left ventricular function in patients with fibrotic interstitial lung diseases. [Tesi di dottorato]


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Item Type: Tesi di dottorato
Resource language: English
Title: Impaired right and left ventricular function in patients with fibrotic interstitial lung diseases
Buonauro, Agostinostino84@gmail.com
Date: 4 March 2020
Number of Pages: 26
Institution: Università degli Studi di Napoli Federico II
Department: Scienze Biomediche Avanzate
Dottorato: Medicina clinica e sperimentale
Ciclo di dottorato: 32
Coordinatore del Corso di dottorato:
Beguinot, francescobeguino@unina.it
Galderisi, MaurizioUNSPECIFIED
Date: 4 March 2020
Number of Pages: 26
Keywords: Interstitial lung diseases, Idiopathic pulmonary fibrosis, Speckle Tracking Echocardiography, Global longitudinal strain, Pulmonary hypertension
Settori scientifico-disciplinari del MIUR: Area 06 - Scienze mediche > MED/09 - Medicina interna
Area 06 - Scienze mediche > MED/11 - Malattie dell'apparato cardiovascolare
Date Deposited: 26 Mar 2020 12:09
Last Modified: 10 Nov 2021 14:33
URI: http://www.fedoa.unina.it/id/eprint/13007

Collection description

Background: Interstitial lung diseases (ILDs) include idiopathic (IPF) and no idiopathic pulmonary fibrosis (no-IPF). While left ventricular (LV) and right ventricular (RV) dysfunction is known in IPF, little is known about cardiac involvement in no-IPF. This issue can be explored by advanced echocardiography. Methods: Sixty-one clinically stable and therapy-naïve fibrotic ILDs patients - 33 IPF and 28 no-IPF, and 30 healthy controls were enrolled after excluding patients with coronary artery disease, overt heart failure, primary cardiomyopathies, other forms of diffuse parenchymal lung disease, history of pulmonary embolism and primary pulmonary arterial hypertension(PAH). ILDs diagnosis was made by chest radiography, spirometry and chest high-resolution computed tomography. Lung cumulative damage was evaluated by diffusion capacity of the lung for carbon monoxide (DLCOsb). All patients underwent a complete echo-Doppler exam including 2D quantitation of global longitudinal strain (GLS) of both ventricles and of RV ejection fraction (EF) by 3D echo. Results: Our findings demonstrated LV diastolic dysfunction in both IPF and no-IPF patients, whilst a subclinical reduction of LV GLS - but not of LV EF - was found only in PF patients. An alteration of and diastolic function and of RV GLS was observed in IPF in comparison with both controls and no-IPF. An association between DLCOsb and RV GLS was found in the pooled ILDs population and in IPF, it being independent on confounders including pulmonary arterial systolic pressure. Conclusion: These findings point out the diagnostic capabilities of strain imaging in distinguishing early cardiac damage of IPF from and no-IPF patients, a task which cannot be attributed to both standard and 3D echocardiography.


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