Background: 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. The aim of this study was to evaluate LV performance in IPF patients using color Doppler echocardiography (ECHO).
Methods: Fifty patients with IPF (mean age 57.8±6.3yrs) and 50 matched control subjects (57.1±5.9 yrs) were studied. Color Doppler echocardiography was used for the evaluation of RV and LV systolic and diastolic function. Left ventricular systolic dysfunction and other causes of Left ventricular diastolic dysfunction (eg, coronary artery disease) were excluded in all patients and control subjects.
Results: The maximal atrial filling velocity was increased and the early filling velocity was decreased in patients with IPF compared to control subjects (0.63±0.15 vs 0.86±0.11 & 0.78±0.13 vs 0.46±0.12 respectively; p <0.001).The early flow velocity peak/late flow velocity peak (E/A) ratio was markedly decreased in patients with IPF compared to control subjects (0.87±0.33 vs 1.5±0.22, respectively; p<0.001). IPF patients also exhibited marked prolongation of deceleration time (224.7±17.4 vs 179.7±16.1, respectively; p<0.001), all indicating the presence of Left ventricular (LV) diastolic dysfunction. Systolic pulmonary artery pressure correlated with the E/A ratio (r=-0.495; p<0.0001).There was significant correlation between E/A ratio with %DLCO , PaO2 and % FVC (r= 0.429; p<0.002, r=0.542, p<0.0001 and r= 0.389; p<0.005, respectively). furthermore, the PASP correlated with the PaO2 (r= -0.596; p<0.0001).
Conclusions: Early impairment of Left ventricular diastolic function is present in patients with idiopathic pulmonary fibrosis, so that physicians should be aware by this finding.