Pulmonary embolism (PE) is a life-threatening condition and a leading cause of morbidity and mortality. There have been many advances in the field of PE in the last few years, requiring a careful assessment of their impact on patient care. However, variations

Ambient air pollution, as measured by average PM concentration, is associated with an increase in the rate of decline of FVC in IPF, suggesting a potential mechanistic role for air pollution in the progression of disease.

Idiopathic pulmonary fi brosis (IPF) is a fatal disease with a variable natural history. Pulmonary hypertension (PH) is frequently found in patients with IPF and is associated with an almost threefold increase in the risk of death. 1,2 In pulmonary arterial hypertension (PAH), outcome is directly related to the capacity of the right ventricle (RV) to adapt to elevated afterload. 3 However, the role of RV function is not clearly understood in pulmonary vascular disease related to IPF.Although right-sided heart catheterization (RHC) is the gold standard modality for hemodynamic assessment, Doppler echocardiogram is a complementary method of assessing RV function. While Doppler echocardiogram measurement of the right ventricular systolic pressure (RVSP) has limited accuracy in advanced lung disease, 4,5 several echocardiographic measurements of the RV have been associated with outcomes in PH. Such measurements include tricuspid annular plane systolic excursion (TAPSE) as a measure of RV ejection fraction, 6-8 RV outfl ow tract velocity-time integral (RVOT VTI) as a surrogate for stroke volume, and the presence of "notching" in the Doppler fl ow velocity envelope obtained from the RVOT, indicating elevated pulmonary vascular resistance (PVR). 9,10 We

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