Right Ventricular Functional Reserve in Early-Stage Idiopathic Pulmonary  Fibrosis: An Exercise Two-Dimensional Speckle Tracking Doppler Echocardiography Study.

D'Andrea, Antonello; Stanziola, Anna Agnese; Saggar, Rajan; Saggar, Rajeev; Sperlongano, Simona; Conte, Marianna; D'Alto, Michele; Ferrara, Francesco; Gargani, Luna; LANCELLOTTI, Patrizio; Bossone, Eduardo; RIGHT Heart International NETwork (RIGHT-NET), Investigators

doi:10.1016/j.chest.2018.11.015

Article (Scientific journals)

Right Ventricular Functional Reserve in Early-Stage Idiopathic Pulmonary Fibrosis: An Exercise Two-Dimensional Speckle Tracking Doppler Echocardiography Study.

D'Andrea, Antonello; Stanziola, Anna Agnese; Saggar, Rajan et al.

2019 • In CHEST, 155 (2), p. 297-306

Peer Reviewed verified by ORBi

Permalink
https://hdl.handle.net/2268/291264

DOI
10.1016/j.chest.2018.11.015

PubMed
30543808

Files (1)Send to Details Statistics Bibliography Similar publications

Files

Full Text

1-s2.0-S0012369218327806-main.pdf

Author postprint (684.9 kB)

Download

All documents in ORBi are protected by a user license.

Send to

RIS BibTex APA Chicago Permalink X Linkedin

Details

Keywords :

Adaptation, Physiological; Adult; Blood Gas Analysis; Case-Control Studies; Disease Progression; Echocardiography, Doppler/methods; Echocardiography, Stress/methods; Female; Functional Residual Capacity; Hemodynamics; Humans; Hypertension, Pulmonary/etiology/physiopathology; Idiopathic Pulmonary Fibrosis/complications/diagnostic imaging/mortality/physiopathology; Image Interpretation, Computer-Assisted; Italy; Kaplan-Meier Estimate; Male; Middle Aged; Prognosis; Proportional Hazards Models; Risk Assessment; Severity of Illness Index; Survival Analysis; Vascular Resistance; Ventricular Dysfunction, Right/diagnostic imaging/etiology/mortality; 2D speckle tracking echocardiography; idiopathic pulmonary fibrosis; right ventricle; stress echocardiography

Abstract :

[en] BACKGROUND: The most important determinant of long-term survival in patients with idiopathic pulmonary fibrosis is the right ventricular (RV) adaptation to the increased pulmonary vascular resistance. Our aim was to explore RV contractile reserve during stress echocardiography in early-stage IPF. METHODS: Fifty early-stage patients with IPF and 50 healthy control patients underwent rest and stress echocardiography, including RV two-dimensional speckle tracking echocardiography. At peak exertion, blood gas analysis and spirometry were also assessed. RESULTS: At rest, RV diameters were mildly increased in IPF; however, although RV conventional systolic function indexes were similar between the IPF and control groups, RV global longitudinal strain and RV lateral wall longitudinal strain (LWLS) were significantly reduced in the IPF cohort. During physical exercise, patients with IPF showed a reduced exercise tolerance with lower maximal workload (P < .01), level of oxygen saturation (P < .001), and peak heart rate (P < .01). Systolic and diastolic BP values were similar in both groups. Systolic pulmonary artery pressure (PAPs) increase (ΔPAPs) during exertion was higher in IPF vs healthy subjects (P < .0001); RV LWLS increase (ΔRV LWLS) during exercise was lower in patients with IPF vs control patients (P < .00001). By multivariable analysis, RV LWLS at rest and ΔRV LWLS were directly related to peak exertion capacity, PAPs, and blood oxygen saturation level (Spo(2); P < .0001). Δ RV LWLS was directly related to diffusion lung carbon monoxide (P < .0001). CONCLUSIONS: RV myocardial dysfunction is already present at rest in early-stage IPF and worsens during exertion as detected by two-dimensional speckle-tracking echocardiography. The RV altered contractile reserve appears to be related to reduced exercise tolerability and impaired pulmonary hemodynamic.

Disciplines :

Cardiovascular & respiratory systems

Author, co-author :

D'Andrea, Antonello; Division of Cardiology, Department of Cardio-thoracic and Respiratory Sciences,

Stanziola, Anna Agnese; Section of Respiratory Diseases, Department of Clinical Medicine and Surgery,

Saggar, Rajan; Division of Pulmonary, Critical Care Medicine, Clinical Immunology, and Allergy,

Saggar, Rajeev; Department of Medicine, University of Arizona, Phoenix, AZ.

Sperlongano, Simona; Division of Cardiology, Department of Cardio-thoracic and Respiratory Sciences,

Conte, Marianna; Division of Cardiology, Department of Cardio-thoracic and Respiratory Sciences,

D'Alto, Michele; Division of Cardiology, Department of Cardio-thoracic and Respiratory Sciences,

Ferrara, Francesco; Division of Cardiology, Heart Department, 'Cava de' Tirreni and Amalfi Coast'

Gargani, Luna; Institute of Clinical Physiology, National Research Council, Pisa, Italy.

LANCELLOTTI, Patrizio ; Centre Hospitalier Universitaire de Liège - CHU > > Service de cardiologie

Bossone, Eduardo; Division of Cardiology, Heart Department, 'Cava de' Tirreni and Amalfi Coast'

RIGHT Heart International NETwork (RIGHT-NET), Investigators

Other collaborator :

Bossone, Eduardo

Gargani, Luna

Naeije, Robert

Ferrara, Francesco

Armstrong, William F

Kolias, Theodore John

Bossone, Eduardo

Ferrara, Francesco

Caliendo, Luigi

Cocchia, Rosangela

More authors (53 more)

Language :

English

Title :

Right Ventricular Functional Reserve in Early-Stage Idiopathic Pulmonary Fibrosis: An Exercise Two-Dimensional Speckle Tracking Doppler Echocardiography Study.

Publication date :

February 2019

Journal title :

CHEST

ISSN :

0012-3692

eISSN :

1931-3543

Publisher :

Elsevier, Us il

Volume :

155

Issue :

Pages :

297-306

Peer reviewed :

Peer Reviewed verified by ORBi

Commentary :

Available on ORBi :

since 24 May 2022

Statistics

Number of views

89 (0 by ULiège)

Number of downloads

182 (0 by ULiège)

More statistics

Scopus citations^®

Scopus citations^®
without self-citations

OpenCitations

OpenAlex citations

Bibliography

Sgalla, G., Biffi, A., Richeldi, L., Idiopathic pulmonary fibrosis: diagnosis, epidemiology and natural history. Respirology 21 (2016), 427–437.
Tomassetti, S., Albera, C., Confalonieri, D., Documento AIPO-SIMeR sulla fibrosi polmonare idiopatica. Suplemetnto n1 Fasc, 1, 2015 https://iris.unito.it/handle/2318/1615075#.XBrC3xNKiLI. Accessed January 8, 2018.
American Thoracic Society American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias. Am J Respir Crit Care Med 166:6 (2002), 518–626.
Cottin, V., Crestani, B., Valeyre, D., et al. Diagnosis and management of idiopathic pulmonary fibrosis: French practical guidelines. Eur Respir Rev 23 (2014), 193–214.
Opitz, C., Rosenkranz, S., Ghofrani, H.A., et al. [ESC guidelines 2015 pulmonary hypertension: diagnosis and treatment]. Dtsch Med Wochenschr 141:24 (2016), 1764–1769.
Galiè N., Humbert, M., Vachiery, J.-L., et al. 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J 46:6 (2015), 1855–1856.
Patel, N.M., Lederer, D.J., Borczuk, A.C., Kawut, S.M., Pulmonary hypertension in idiopathic pulmonary fibrosis. Chest 132:3 (2007), 998–1006.
Salisbury, M.L., Xia, M., Zhou, Y., et al. Idiopathic pulmonary fibrosis: gender-age-physiology index stage for predicting future lung function decline. Chest 149:2 (2016), 491–498.
Berend, N., Respiratory disease and respiratory physiology: putting lung function into perspective interstitial lung disease. Respirology 19:7 (2014), 952–959.
Hamada, K., Nagai, S., Tanaka, S., et al. Significance of pulmonary arterial pressure and diffusion capacity of the lung as prognosticator in patients with idiopathic pulmonary fibrosis. Chest 131:3 (2007), 650–656.
Lettieri, C.J., Nathan, S.D., Barnett, S.D., Ahmad, S., Shorr, A.F., Prevalence and outcomes of pulmonary arterial hypertension in advanced idiopathic pulmonary fibrosis. Chest 131:3 (2007), 650–656.
Kimura, M., Taniguchi, H., Kondoh, Y., et al. Pulmonary hypertension as a prognostic indicator at the initial evaluation in idiopathic pulmonary fibrosis. Respiration 85:6 (2013), 456–463.
Veerdonk, M.C., Van De, Kind, T., Marcus, J.T., et al. Progressive right ventricular dysfunction in patients with pulmonary arterial hypertension responding to therapy. J Am Coll Cardiol 58:24 (2011), 2511–2519.
Chaouat, A., Sitbon, O., Mercy, M., et al. Prognostic value of exercise pulmonary haemodynamics in pulmonary arterial hypertension. Eur Respir J 44:3 (2014), 704–713.
Holverda, S., Gan, C.T.J., Marcus, J.T., Postmus, P.E., Boonstra, A., Vonk-Noordegraaf, A., Impaired stroke volume response to exercise in pulmonary arterial hypertension. J Am Coll Cardiol 47:8 (2006), 1732–1733.
Lewis, G.D., Bossone, E., Naeije, R., et al. Pulmonary vascular hemodynamic response to exercise in cardiopulmonary diseases. Circulation 128:13 (2013), 1470–1479.
Nootens, M., Wolfkiel, C.J., Chomka, E.V., Rich, S., Understanding right and left ventricular systolic function and interactions at rest and with exercise in primary pulmonary hypertension. Am J Cardiol 75:5 (1995), 374–377.
Almeida, A.R., Loureiro, M.J., Lopes, L., et al. Echocardiographic assessment of right ventricular contractile reserve in patients with pulmonary hypertension. Rev Port Cardiol 33:3 (2014), 155–163.
Chemla, D., Castelain, V., Hoette, S., et al. Strong linear relationship between heart rate and mean pulmonary artery pressure in exercising patients with severe precapillary pulmonary hypertension. Am J Physiol Heart Circ Physiol 305:5 (2013), H769–H777.
Deboeck, G., Taboada, D., Hagan, G., et al. Maximal cardiac output determines 6 minutes walking distance in pulmonary hypertension. PLoS One, 9(3), 2014, e92324.
Groepenhoff, H., Westerhof, N., Jacobs, W., Boonstra, A., Postmus, P.E., Vonk-Noordegraaf, A., Exercise stroke volume and heart rate response differ in right and left heart failure. Eur J Heart Fail 12:7 (2010), 716–720.
Provencher, S., Chemla, D., Hervé P., Sitbon, O., Humbert, M., Simonneau, G., Heart rate responses during the 6-minute walk test in pulmonary arterial hypertension. Eur Respir J 27:1 (2006), 114–120.
Spruijt, O.A., Man FS de, Groepenhoff, H., et al. The effects of exercise on right ventricular contractility and right ventricular - arterial coupling in pulmonary hypertension. Am J Respir Crit Care Med 191:9 (2015), 1050–1057.
Sachdev, A., Villarraga, H.R., Frantz, R.P., et al. Right ventricular strain for prediction of survival in patients with pulmonary arterial hypertension. Chest 139:6 (2011), 1299–1309.
D'Andrea, A., Stanziola, A., Palma E Di, et al. Right ventricular structure and function in idiopathic pulmonary fibrosis with or without pulmonary hypertension. Echocardiography 222 (2016), 908–910.
Ferrara, F., Gargani, L., Armstrong, W.F., et al. The Right Heart International Network (RIGHT-NET): rationale, objectives, methodology, and clinical implications. Heart Fail Clin 14:3 (2018), 443–465.
Grünig, E., Tiede, H., Enyimayew, E.O., et al. Assessment and prognostic relevance of right ventricular contractile reserve in patients with severe pulmonary hypertension. Circulation 12:18 (2013), 2005–2015.
Naeije, R., Saggar, R., Badesch, D., et al. Exercise-induced pulmonary hypertension: translating pathophysiological concepts into clinical practice. Chest 154:1 (2018), 10–15.
Kovacs, G., Herve, P., Barbera, J.A., et al. An official European Respiratory Society statement: pulmonary haemodynamics during exercise. Eur Respir J, 50(5), 2017 pii: 1700578.
Travis, W.D., Costabel, U., Hansell, D.M., et al. An official American Thoracic Society/European Respiratory Society statement: update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med 188:6 (2013), 733–748.
Raghu, G., Collard, H.R., Egan, J.J., et al. An Official ATS/ERS/JRS/ALAT Statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med 183:6 (2011), 788–824.
Lang, R.M., Badano, L.P., Mor-Avi, V., et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 16:3 (2015), 233–270.
Lancellotti, P., Tribouilloy, C., Hagendorff, A., et al. Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 14:7 (2013), 611–644.
Baumgartner, H., Hung, J., Bermejo, J., et al. Recommendations on the echocardiographic assessment of aortic valve stenosis: a focused update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. J Am Soc Echocardiogr 30:4 (2017), 372–392.
Chemla, D., Castelain, V., Humbert, M., et al. New formula for predicting mean pulmonary artery pressure using systolic pulmonary artery pressure. Chest 126:4 (2004), 1313–1317.
Nagueh, S.F., Smiseth, O.A., Appleton, C.P., et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 17:12 (2016), 1321–1360.
Korinek, J., Kjaergaard, J., Sengupta, P.P., et al. High spatial resolution speckle tracking improves accuracy of 2-dimensional strain measurements: an update on a new method in functional echocardiography. J Am Soc Echocardiogr 20:2 (2007), 165–170.
Yang, H.S., Mookadam, F., Warsame, T.A., Khandheria, B.K., Tajik, J.A., Chandrasekaran, K., Evaluation of right ventricular global and regional function during stress echocardiography using novel velocity vector imaging. Eur J Echocardiogr 11:2 (2010), 157–164.
Miller, D., Farah, M.G., Liner, A., Fox, K., Schluchter, M., Hoit, B.D., The relation between quantitative right ventricular ejection fraction and indices of tricuspid annular motion and myocardial performance. J Am Soc Echocardiogr 17:5 (2004), 443–447.
D'Andrea, A., Stanziola, A., D'Alto, M., et al. Right ventricular strain: an independent predictor of survival in idiopathic pulmonary fibrosis. Int J Cardiol 222 (2016), 908–910.
D'Alto, M., Romeo, E., Argiento, P., et al. Accuracy and precision of echocardiography versus right heart catheterization for the assessment of pulmonary hypertension. Int J Cardiol 168:4 (2013), 4058–4062.
Dalen, H., Thorstensen, A., Aase, S.A., et al. Segmental and global longitudinal strain and strain rate based on echocardiography of 1266 healthy individuals: the HUNT study in Norway. Eur J Echocardiogr 11:2 (2010), 176–183.
Reeves, J., Dempsey, J., Grover, R., Pulmonary circulation during exercise. Weir, E., Reeves, J., (eds.) Pulmonary Vascular Physiology and Physiopathology, 1989, Dekker, New York, 107–133.
Bidart, C.M., Abbas, A.E., Parish, J.M., Chaliki, H.P., Moreno, C.A., Lester, S.J., The noninvasive evaluation of exercise-induced changes in pulmonary artery pressure and pulmonary vascular resistance. J Am Soc Echocardiogr 20:3 (2007), 270–275.
Rudski, L.G., Lai, W.W., Afilalo, J., et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 23:7 (2010), 685–713.
Gerche A La, Roberts, T.J., Straining the RV to predict the future. JACC Cardiovasc Imaging 8:2 (2015), 170–171.