Assessment of right and left ventricular functions in interstitial lung diseases

Abstract

Background Subclinical or overt cardiovascular affection in patients with interstitial lung diseases (ILD) may expect to have increased mortality and/or reduced exercise capacity. Objective Echocardiographic (echo) assessment of right ventricular (RV) and left ventricular (LV) functions in patients with ILD. Patients and methods Conventional echo, tissue Doppler imaging (TDI) and two-dimensional speckle tracking echo (2D STE), spirometry [forced vital capacity (FVC%), forced expiratory volume in 1 s% and forced expiratory volume in 1 s/FVC], and functional exercise capacity (6 min walking test) were performed on 60 patients with ILD and 60 age-matched and sex-matched controls. Pulmonary involvement was identified in high-resolution computed tomography (HRCT) and scored according to a semiquantitative Warrick score. Results Using conventional echo-Doppler, TDI, and 2D STE, there are statistically significant impairments in both RV systolic and diastolic functions, as well as LV diastolic functions in ILD patients compared with controls (P<0.05). LV systolic dysfunction was detected by TDI and STE only; however, ejection fraction was normal by standard echo. In the ILD group, the tricuspid annular plane systolic excursion was positively correlated with PaO2 and FVC%, while it was negatively correlated with the HRCT score. RV global longitudinal strain% was positively correlated with both 6 min walking distance and FVC%. Moreover, LV global longitudinal strain% was positively correlated with both 6 min walking distance and PaO2, while it was negatively correlated with HRCT score. Conclusion Both RV and LV systolic and diastolic dysfunctions were detected by echo in ILD patients. Ventricular dysfunctions were related to hypoxemia, radiological score, and vital capacity of the lungs. Ventricular dysfunction has a negative impact on function exercise capacity of patients with ILD.