scholarly journals 24-Hour Hypoxia and Pulmonary Hypertension in Patients with Idiopathic Pulmonary Fibrosis

2017 ◽  
Vol 11 (1) ◽  
pp. 10-16 ◽  
Author(s):  
Marcelo P. Rodrigues ◽  
Carolina M. Vissoci ◽  
Samuel P. Rosa ◽  
Sandra B.C. Negreiros
Keyword(s):  
Pulmonary Hypertension ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Cross Sectional Study ◽  
Arterial Oxygen ◽  
Systolic Pulmonary Artery Pressure ◽  
Cross Sectional ◽  
Transthoracic Doppler Echocardiography ◽  
Percent Time ◽  
Gas Measurement

Background:The quantification of hypoxia based on resting partial pressure of arterial oxygen (PaO2) may underestimate hypoxia related to activities of daily living or sleep and thus not accurately reflect pulmonary hypertension (PH). The aim of the present study was to investigate the association of resting PaO2with percent time of SpO2below 90% (T90) and 88% (T88) in 24 hours. We also evaluated the capacity of hypoxia measures to predict PH in patients with idiopathic pulmonary fibrosis (IPF).Method:This cross-sectional study included 27 patients with IPF presenting PaO2≥ 55 mmHg and not receiving home oxygen therapy. All were submitted to blood gas measurement, 24-h oximetry, and transthoracic Doppler echocardiography to estimate systolic pulmonary artery pressure (SPAP). Patients were divided into three groups according to resting PaO2: 55-55.9 mmHg (A); 60-60.9 mmHg (B); ≥ 70 mmHg (C). PH was defined as “likely” if SPAP > 50 mmHg, and as possible for SPAP between 37 and 50 mmHg.Results:T90 and T88 in Groups A, B, and C were as follows: 59.9±29% and 44.1±34%; 49.3±34% and 29.9±31%; 17.1±25% and 8.8±18% respectively, with significant differences between the groups for both T90 (p ≤ 0.01) and T88 (p = 0.02). PaO2was inversely correlated with T90 (r = -0.398;p = 0.04) and T88 (r = -0.351;p = 0.07). Hypoxia variables did not correlate with SPAP, and were not able to predict PH.Conclusion:Percent time of SpO2below 90% and 88% in 24 hours revealed periods of severe hypoxia even in patients with borderline-normal resting PaO2. However, none of the present hypoxia variables was capable of predicting PH.

scholarly journals What are the best indicators to assess malnutrition in idiopathic pulmonary fibrosis patients? A cross-sectional study in a referral center

Nutrition ◽  
2019 ◽  
Vol 62 ◽  
pp. 115-121 ◽  
Author(s):  
Stéphane Jouneau ◽  
Mallorie Kerjouan ◽  
Chloé Rousseau ◽  
Mathieu Lederlin ◽  
Francisco Llamas-Guttierez ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Referral Center

scholarly journals Periostin and closing volume in combined pulmonary fibrosis and emphysema

2020 ◽  
Author(s):  
Fernando Medeiros Anselmo ◽  
Cláudia Henrique da Costa ◽  
Luciana Silva Rodrigues ◽  
Thaís Porto Amadeu ◽  
Mariana Martins de Athaide ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Pulmonary Function Tests ◽  
Cross Sectional Study ◽  
Chronic Obstructive ◽  
Closing Volume ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Diffusion Capacity ◽  
Characterization Methods

Abstract Background Combined pulmonary fibrosis and emphysema (CPFE) is an entity characterized by the presence of emphysema in upper lobes and fibrosis in lower lobes. Due to the presence of the two diseases concomitantly, it may be difficult to diagnose. This study aims at a better understanding of this entity and proposes biological markers (functional and biochemical) that help in this characterization. Methods A prospective, observational, cross-sectional study was carried out at a reference center. Pulmonary function tests (spirometry, CO-diffusion capacity, plethysmography and single-maneuver nitrogen washout test - SBWN 2 ) and biochemical markers (periostin, mucin-16, PDGF-BB and TGF-β 1 ) were measured in groups of patients: idiopathic pulmonary fibrosis, CPFE and chronic obstructive pulmonary disease (COPD). Results Variables derived from SBWN 2 - closing volume (CV) / vital capacity (VC) (%) and closing capacity (CC) / total lung capacity (TLC) (%) - were found to be higher in the CPFE group compared to the Idiopathic pulmonary fibrosis (IPF) group (CV/VC%: 0.25 (0.12 – 11.01) and 13.05 (0.21 – 20.73); p = 0.005; CC/TLC%: 30.1 (22.4 – 37.47) and 33.69 (32.05 – 41.98); p = 0.03, respectively). Periostin was higher in the CPFE group than in the other groups [CPFE: 66.74 (45.21 – 90.5), IPF: 43.81 (31.97 – 56.18), COPD: 40.08 (20.66 – 50.81); p = 0.0002], and mucin-16 was higher in the IPF group than in the CPFE group [CPFE: 13.59 (4.16 – 28.16); IPF: 71.94 (40.46 - 164); COPD: 25.85 (9.27 – 30.29); p = 0.02]. Conclusions Findings show that CPFE presents different functional and biochemical characteristics than IPF, including higher CV/VC%, CC/TLC% and periostin, whereas mucin-16 was higher in the IPF.

scholarly journals Serum calprotectin as new biomarker for disease severity in idiopathic pulmonary fibrosis: a cross-sectional study in two independent cohorts

2021 ◽  
Vol 8 (1) ◽  
pp. e000827 ◽  
Author(s):  
Carlos Machahua ◽  
Sabina A. Guler ◽  
Michael P. Horn ◽  
Lurdes Planas-Cerezales ◽  
Ana Montes-Worboys ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Disease Severity ◽  
Validation Cohort ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Sectional Study ◽  
Cross Sectional ◽  
Derivation Cohort

BackgroundNon-invasive biomarkers for the assessment of disease severity in idiopathic pulmonary fibrosis (IPF) are urgently needed. Calprotectin belongs to the S-100 proteins produced by neutrophils, which likely contribute to IPF pathogenesis. Calprotectin is a well-established biomarker in inflammatory bowel diseases. In this cross-sectional study, we aimed to establish the potential role of calprotectin as a biomarker in IPF. Specifically, we hypothesised that patients with IPF have higher serum calprotectin levels compared with healthy controls, and that calprotectin levels are associated with disease severity.MethodsBlood samples were obtained from healthy volunteers (n=26) and from two independent IPF cohorts (derivation cohort n=26, validation cohort n=66). Serum calprotectin levels were measured with a commercial kit adapted for that purpose and compared between healthy controls and patients with IPF. Clinical parameters, including forced vital capacity, diffusing capacity for carbon monoxide (DLCO) and the Composite Physiologic Index (CPI), were correlated with calprotectin serum levels.ResultsThe IPF derivation cohort showed increased serum calprotectin levels compared with healthy controls (2.47±1.67 vs 0.97±0.53 µg/mL, p<0.001). In addition, serum calprotectin levels correlated with DLCO% predicted (r=−0.53, p=0.007) and with CPI (r=0.66, p=0.007). These findings were confirmed in an independent IPF validation cohort.ConclusionSerum calprotectin levels are significantly increased in patients with IPF compared with healthy controls and correlate with DLCO and CPI. Calprotectin might be a potential new biomarker for disease severity in IPF.

scholarly journals Pulmonary hypertension associated with idiopathic pulmonary fibrosis: morphofunctional characteristics of pulmonary artery branches and their relationship with functional cardiorespiratory status

2007 ◽  
pp. 23-28
Author(s):  
G. V. Nekludova ◽  
A. L. Nekludova ◽  
A. V. Chernyak ◽  
S. N. Avdeev ◽  
Zh. K. Naumenko ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Pulmonary Artery ◽  
Sectional Area ◽  
Diffusing Capacity ◽  
Cardiorespiratory System ◽  
Cross Sectional ◽  
Vessel Lumen ◽  
The Right

The aim of the study was to investigate functional status of cardiorespiratory system and post-mortem morphometric characteristics of the heart and the lung arteries in secondary pulmonary hypertension (PH) associated with idiopathic pulmonary fibrosis (IPF). A retrospective analysis of functional status of cardiorespiratory system in 10 died patients with IPF (5 males and 5 females, the average age, 63.1 ± 9.2 yrs) was performed. During the last 6 months of their life, all the patients were investigated using body plethysmography, lung diffusing capacity test, arterial blood gas analysis and Doppler echocardiography measuring maximal systolic pulmonary artery (PA) pressure (sysPAP). We also performed histological examination of autopsy samples and morphometric examination of the PA and the heart. Severe restrictive disorders, significant decrease in the lung diffusing capacity with alveolo-capillary block and arterial hypoxemia have been found. The sysPAP was 44.9 ± 17.4 mm Hg in average. Microscopic lung tissue disorders were characteristic for usual interstitial pneumonia. Diameter of the pulmonary vessel lumen in IPF patients was 1.5-fold less and the vessel area was 1.7-fold less than those in controls. In IPF patients, the PA branch wall was 2.9-fold thicker, the proportion of the muscle area was 2.2-fold more and that of the intima area was 4.1-fold more than those in controls. Correlations were found between sysPAP and the cross-sectional area f the PA small branches (r = 0.71; p < 0.05), sysPAP and the proportion of intima area (r = 0.68, p < 0.05). Lumen diameter of the PA small branches correlated with the right atrium length (r = –0.81; p < 0.05) and the right ventricle mass correlated with diameter (r = –0.71; p < 0.05) and the cross-sectional area of the PA small branches (r = –0.75; p < 0.05). Significant correlations were also found between lung function, lung diffusing capacity and function signs of PH. Therefore, secondary PH in IPF is characterized by wall remodeling in the PA branches, mainly due to changes of intima. The 1.5-fold reduction of the vessel lumen is thought to be a cause of moderate growth of sysPAP followed by occurrence of cor pulmonale.

scholarly journals Right ventricular dysfunction in patients with non-severe idiopathic pulmonary fibrosis: a cross-sectional prospective single-center study

2020 ◽  
Author(s):  
Sandra de Barros Cobra ◽  
Marcelo Palmeira Rodrigues ◽  
Felipe Xavier de Melo ◽  
Nathali Mireise Costa Ferreira ◽  
Viviane Vieira Passini Soares ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Right Ventricular ◽  
Speckle Tracking ◽  
Oxygen Therapy ◽  
Ventricular Dysfunction ◽  
Speckle Tracking Echocardiography ◽  
Right Ventricular Dysfunction ◽  
Cross Sectional

Abstract Background Pulmonary hypertension worsens the prognosis of idiopathic pulmonary fibrosis (IPF) and is associated with chronic respiratory failure in advanced disease. However, little is known about the occurrence of pulmonary hypertension and subsequent right ventricular dysfunction in non-advanced IPF patients without hypoxemia at rest. We evaluated right ventricular dysfunction in non-advanced IPF patients and examined the association of right ventricular dysfunction with mean pulmonary artery pressure (mPAP) at rest and during exercise.Methods This cross-sectional study included patients with blood oxygen saturation levels ≥92% at rest, Gender-Age-Physiology Index score ≤5, modified Medical Research Council dyspnea scale score ≤3, and no history of oxygen therapy. Patients underwent transthoracic echocardiography at rest and during cardiopulmonary exercise. Ventricular function was analyzed by measuring conventional parameters and right ventricular global longitudinal strain using two-dimensional speckle-tracking echocardiography. Means were compared using t-test for independent samples. Results Abnormal speckle-tracking echocardiography findings were identified in 10/27 patients (37%), indicating right ventricular dysfunction (mean mPAP: 21.6 ± 5.5 mmHg at rest, 42.2 ± 14.1 mmHg during maximal exercise). Significant differences in mPAP were observed between patients with right ventricular dysfunction and those without dysfunction (at rest: 26.0 ± 4.8 vs. 19.1 ± 4.2 mmHg, p = 0.001; during exercise: 51.3 ± 6.4 vs. 36.9 ± 14.7 mmHg, p = 0.002). Right ventricular dysfunction was detected in 37% of non-advanced IPF patients and was associated with increased mPAP at rest and during exercise. Early recognition was only possible using speckle-tracking echocardiography. Conclusions Right ventricular dysfunction was detected in 37% of non-advanced IPF patients and was associated with increased mPAP at rest and during exercise. Special attention should be given to these patients; as right ventricular dysfunction is suggestive of worse prognosis. These patients could benefit from new specific drugs or even oxygen therapy for transitory hypoxia.

scholarly journals Alterations in Plasma miR-21, miR-590, miR-192 and miR-215 in Patients with Idiopathic Pulmonary Fibrosis and Their Clinical Importance

2021 ◽  
Author(s):  
Hulya Dirol ◽  
Aslı Toylu ◽  
Aliye Candan Ogus ◽  
Aykut Cilli ◽  
Omer Ozbudak ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Plasma Levels ◽  
Pulmonary Function Tests ◽  
Clinical Importance ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Pulmonary Physiology ◽  
Significant Difference ◽  
And Control

Abstract Background: It is well-established that microRNAs (miRNAs) have regulatory roles in the fibrotic processes of various tissues. Studies revealed that some miRNAs play a pivotal role in the development of idiopathic pulmonary fibrosis (IPF). Methods: In this single-center, cross-sectional study, the plasma levels of miR-21, miR-590, miR-192, and miR-215 in IPF (n=88) and the control (n=20) group were investigated using real-time PCR. The pulmonary function tests and the plasma sampling of participants were carried out simultaneously. Patients were grouped according to age, forced vital capacity, diffusing capacity for carbon monoxide (DLCO), and the Gender-Age-pulmonary Physiology (GAP) score. The expression levels of the target miRNAs between these clinical subgroups were compared.Results: The IPF and control groups were similar in terms of gender and age. The mean plasma miR-21 and miR-590 levels in IPF were significantly higher than in the control (p<0.0001, p<0.0001, respectively). There was no significant difference in miR-192 and miR-215 levels between the groups. While miR-21 and miR-590 correlated positively with age (p=0.041, p=0.007, respectively), miR-192 and miR-215 displayed a negative correlation with age (p=0.0002, p<0.0001, respectively). MiR-192 and miR-215 increased as the GAP score decreased and miR-192 level in patients with honeycombing was significantly lower than in those without honeycombing (p=0.003).Conclusions: Our results suggest that higher plasma levels of miR-21 and miR-590 were related to the presence of IPF. While all target miRNAs correlated with age, the miR-21 and miR-590 were associated with DLCO, and miR-192 and miR-215 were associated with GAP score and honeycombing.

scholarly journals Right ventricular dysfunction in patients with non-severe idiopathic pulmonary fibrosis: a cross-sectional prospective single-center study

2020 ◽  
Author(s):  
Sandra de Barros Cobra ◽  
Marcelo Palmeira Rodrigues ◽  
Felipe Xavier de Melo ◽  
Nathali Mireise Costa Ferreira ◽  
Viviane Vieira Passini Soares ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Right Ventricular ◽  
Speckle Tracking ◽  
Oxygen Therapy ◽  
Ventricular Dysfunction ◽  
Speckle Tracking Echocardiography ◽  
Right Ventricular Dysfunction ◽  
Cross Sectional

Abstract Background Pulmonary hypertension worsens the prognosis of idiopathic pulmonary fibrosis (IPF) and is associated with chronic respiratory failure in advanced disease. However, little is known about the occurrence of pulmonary hypertension and subsequent right ventricular dysfunction in non-advanced IPF patients without hypoxemia at rest. We evaluated right ventricular dysfunction in non-advanced IPF patients and examined the association of right ventricular dysfunction with mean pulmonary artery pressure (mPAP) at rest and during exercise. Methods This cross-sectional study included patients with blood oxygen saturation levels ≥92% at rest, Gender-Age-Physiology Index score ≤5, modified Medical Research Council dyspnea scale score ≤3, and no history of oxygen therapy. Patients underwent transthoracic echocardiography at rest and during cardiopulmonary exercise. Ventricular function was analyzed by measuring conventional parameters and right ventricular global longitudinal strain using two-dimensional speckle-tracking echocardiography. Means were compared using the t-test for independent samples.Results Abnormal speckle-tracking echocardiography findings were identified in 10/27 patients (37%), indicating right ventricular dysfunction (mean mPAP: 21.6 ± 5.5 mmHg at rest, 42.2 ± 14.1 mmHg during maximal exercise). Significant differences in mPAP were observed between patients with right ventricular dysfunction and those without dysfunction (at rest: 26.0 ± 4.8 vs. 19.1 ± 4.2 mmHg, p = 0.001; during exercise: 51.3 ± 6.4 vs. 36.9 ± 14.7 mmHg, p = 0.002). Right ventricular dysfunction was detected in 37% of non-advanced IPF patients and was associated with increased mPAP at rest and during exercise. Early recognition was only possible using speckle-tracking echocardiography.Conclusions Right ventricular dysfunction was detected in 37% of non-advanced IPF patients and was associated with increased mPAP at rest and during exercise. Special attention should be given to these patients as right ventricular dysfunction is suggestive of worse prognosis. These patients could benefit from new specific drugs or even oxygen therapy for transitory hypoxia.

scholarly journals Right ventricular dysfunction in patients with non-severe idiopathic pulmonary fibrosis: a cross-sectional prospective single-center study

2019 ◽  
Author(s):  
Sandra de Barros Cobra ◽  
Marcelo Palmeira Rodrigues ◽  
Felipe Xavier de Melo ◽  
Nathali Mireise Costa Ferreira ◽  
Viviane Vieira Passini Soares ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Right Ventricular ◽  
Speckle Tracking ◽  
Oxygen Therapy ◽  
Ventricular Dysfunction ◽  
Speckle Tracking Echocardiography ◽  
Right Ventricular Dysfunction ◽  
Cross Sectional

Abstract Background: Pulmonary hypertension worsens the prognosis of idiopathic pulmonary fibrosis (IPF) and is associated with chronic respiratory failure in advanced disease. However, little is known about the occurrence of pulmonary hypertension and subsequent right ventricular dysfunction in non-advanced IPF patients without hypoxemia at rest. We evaluated right ventricular dysfunction in non-advanced IPF patients and examined the association of right ventricular dysfunction with mean pulmonary artery pressure (mPAP) at rest and during exercise. Methods: This cross-sectional study included patients with blood oxygen saturation levels ≥92% at rest, Gender-Age-Physiology Index ≤5, modified Medical Research Council scale score ≤3, and no history of oxygen therapy. Patients underwent transthoracic echocardiography at rest and during cardiopulmonary exercise. Ventricular function was analyzed by measuring conventional parameters and right ventricular global longitudinal strain using two-dimensional speckle-tracking echocardiography. The t-test was used to compare means of independent samples. Results: Abnormal speckle-tracking echocardiography findings were identified in 10/27 patients (37%), indicating right ventricular dysfunction (mean mPAP: 21.6 ± 5.5 mmHg at rest, 42.2 ± 14.1 mmHg during maximal exercise). Significant differences in mPAP were observed between patients with right ventricular dysfunction and those without dysfunction (at rest: 26.0 ± 4.8 vs. 19.1 ± 4.2 mmHg, p = 0.001; during exercise: 51.3 ± 6.4 vs. 36.9 ± 14.7 mmHg, p = 0.002). Right ventricular dysfunction was detected in 37% of non-advanced IPF patients and was associated with increased mPAP at rest and during exercise. Early recognition was only possible using speckle-tracking echocardiography. Conclusions: Right ventricular dysfunction was detected in 37% of non-advanced IPF patients and was associated with increased mPAP at rest and during exercise. Special attention should be given to these patients, as right ventricular dysfunction is suggestive of worse prognosis. These patients could benefit from new specific drugs or even oxygen therapy for transitory hypoxia.

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