Right ventricular contractility decreases during exercise in patients with non-advanced idiopathic pulmonary fibrosis.

Autor:	Cobra SB; Department of Cardiology, Federal District Base Hospital Institute and School of Medicine, University of Brasília, Brasília 70.330-150 - DF., Rodrigues MP; Department of Pulmonology, School of Medicine, University of Brasília., de Melo FX; Department of Pulmonology, University Hospital of Brasília., Ferreira NMC; Department of Pulmonology, School of Medicine., Melo-Silva CA; Laboratory of Respiratory Physiology, University of Brasília.; Division of Physical Therapy, University Hospital of Brasília, Brasília 70.910-900 - DF.; Núcleo de Integração Funcional, Rehabilitation Center, Brasília 70.830-350 - DF, Brazil.
Jazyk:	angličtina
Zdroj:	Medicine [Medicine (Baltimore)] 2021 Jul 09; Vol. 100 (27), pp. e25915.
DOI:	10.1097/MD.0000000000025915
Abstrakt:	Abstract: Early right ventricular dysfunction in patients with non-advanced idiopathic pulmonary fibrosis (IPF) has not been fully elucidated. Thus, we aimed to assess right ventricular functions in IPF patients and controls by speckle-tracking strain echocardiography at rest and peak exercise.We screened 116 IPF patients from February to August 2019 to include 20 patients with no history of oxygen therapy, peripheral saturation levels ≥92% at rest, Gender-Age-Physiology Index score ≤5, and modified Medical Research Council score ≤3. Additionally, we enrolled 10 matched controls. Transthoracic echocardiography images were acquired at rest and during a cardiopulmonary exercise test. We analyzed 2-dimensional echocardiographic parameters and right ventricular function using the global longitudinal strain assessed by the 2-dimensional speckle-tracking technique.In the control group, we found normal values of right ventricle longitudinal strain (RVLS) at rest and at peak exercise, the latter being much more negative (-23.6 ± 2.2% and -26.8 ± 3.1%, respectively; P < .001). By contrast, RVLS values in the IPF group increased from -21.1 ± 3.8% at rest to -17.0 ± 4.5% at peak exercise (P < .001). The exercise revealed a difference between the 2 groups as the mean RVLS values moved during peak exercise in opposite directions. Patients with IPF got worse, whereas control patients presented improved right ventricular contractility.Right ventricular dysfunction was unveiled by speckle-tracking echocardiography during exercise in non-advanced IPF patients. We suggest that this reflects an inadequate right ventricular-arterial coupling decreasing the right ventricular longitudinal contraction during exercise in these patients. This parameter may be useful as an early index of suspected pulmonary hypertension. Competing Interests: The authors have no funding and conflicts of interest to disclose. (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu