Early left atrial dysfunction in idiopathic pulmonary fibrosis patients without chronic right heart failure

<p>Raw data related to the article.</p> <p>Abstract</p> <p>No data are actually available regarding the left atrial (LA) functional assessment by two-dimensional speckle tracking<br> echocardiography (2D-STE) in early-stage idiopathic pulmonary fibrosis (IPF). The primary end-point of our study was to<br> assess whether global LA peak strain (GLAPS), measured by 2D-STE analysis, may detect early alterations in LA function<br> in IPF patients without right heart failure (RHF). Between September 2017 and January 2019, 50 consecutive IPF patients<br> (73.8 &plusmn; 6.8 years, 36 males) without chronic RHF and 30 controls matched by age, sex and cardiovascular risk factors, were<br> enrolled in an observational retrospective case&ndash;control study. All patients underwent a complete echocardiographic study<br> implemented with 2D-STE analysis. GLAPS, left ventricular (LV) global longitudinal strain (GLS), right atrial (RA) reservoir<br> strain (GSA+) and right ventricular (RV)-GLS were obtained in each patient. LVFP were significantly increased in<br> IPF patients in comparison to controls (average E/e&prime; ratio 14.4 &plusmn; 3.0 vs 9.6 &plusmn; 1.5, p &lt; 0.0001), while LV-GLS was slightly<br> reduced in IPF patients compared to controls (19.4 &plusmn; 3.6% vs 21.0 &plusmn; 2.2%, p = 0.03).Moreover, GLAPS was significantly<br> impaired in IPF patients in comparison to controls (18.4 &plusmn; 3.7% vs 28.4 &plusmn; 5.6%, p &lt; 0.0001).Finally, the two groups of<br> patients did not show any statistically significant difference in both RA-GSA + (23.9 &plusmn; 3.7% vs 24.5 &plusmn; 4.0%, p = 0.49)<br> and RV-GLS (&minus; 22.6 &plusmn; 3.3% vs &minus; 23.5 &plusmn; 3.0%, p = 0.22). Notably, LV-GLS was strongly inversely correlated both with<br> RV/LV basal diameter ratio and TRV in IPF patients (r = &minus; 0.87 and &minus; 0.82, respectively) but not in controls (r = &minus; 0.29<br> and &minus; 0.27, respectively). This finding highlights a likely process of ventricular interdependence in non-advanced IPF, with<br> consequent LV diastolic dysfunction and secondary impairment in LV-GLS and GLAPS. Early LA reservoir dysfunction in<br> IPF patients may be secondary to LV diastolic dysfunction induced by ventricular interdependence and may develop before<br> RV diastolic and systolic dysfunction.</p>