Idiopathic pulmonary fibrosis and coronary artery disease

Cicchitto, Gaetano; Musella, Valentina; Acitorio, Maria; Capuano, Nicola; Fiorenzano, Giuseppe; Owen, Caroline A.; Polverino, Mario; Polverino, Francesca

doi:10.1186/2049-6958-9-31

Cited by 5 publications

(6 citation statements)

References 19 publications

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“…Guidelines currently recommend pulmonary rehabilitation for most IPF patients, although it is highlighted how programmes need to be tailored [93]. CPET therefore represents a crucial element for better selecting patients, designing personalised training and rehabilitation protocols and more accurate evaluating outcomes of response [85,94,95].…”

Section: Exercise Training and Pulmonary Rehabilitation In Ildmentioning

confidence: 99%

Exertional dyspnoea in interstitial lung diseases: the clinical utility of cardiopulmonary exercise testing

Bonini

Fiorenzano

2017

Eur Respir Rev

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Interstitial lung diseases (ILDs) represent a heterogeneous group of pathologies characterised by alveolar and interstitial damage, pulmonary inflammation (usually associated with fibrosis), decreased lung function and impaired gas exchange, which can be attributed to either a known or an unknown aetiology. Dyspnoea is one of the most common and disabling symptoms in patients with ILD, significantly impacting quality of life. The mechanisms causing dyspnoea are complex and not yet fully understood. However, it is recognised that dyspnoea occurs when there is an imbalance between the central respiratory efferent drive and the response of the respiratory musculature. The respiratory derangement observed in ILD patients at rest is even more evident during exercise. Pathophysiological mechanisms responsible for exertional dyspnoea and reduced exercise tolerance include altered respiratory mechanics, impaired gas exchange, cardiovascular abnormalities and peripheral muscle dysfunction.This review describes the respiratory physiology of ILD, both at rest and during exercise, and aims to provide comprehensive and updated evidence on the clinical utility of the cardiopulmonary exercise test in the assessment and management of these pathological entities. In addition, the role of exercise training and pulmonary rehabilitation programmes in the ILD population is addressed.

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Section: Exercise Training and Pulmonary Rehabilitation In Ildmentioning

confidence: 99%

Exertional dyspnoea in interstitial lung diseases: the clinical utility of cardiopulmonary exercise testing

Bonini

Fiorenzano

2017

Eur Respir Rev

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“…It also provides insight into whether or not these patients are a candidate for a lung transplant. 25 Nathan et al have demonstrated the utility of CTA to look for coronary calcifications to predict further cardiac workup requirements in patients with IPF. 26 …”

Section: Discussionmentioning

confidence: 99%

A Step towards understanding coronary artery disease: a complication in idiopathic pulmonary fibrosis

Sinha,

Nanavaty,

Azhar

et al. 2024

BMJ Open Resp Res

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BackgroundIdiopathic pulmonary fibrosis (IPF) is a relatively rare disease with increasing incidence trends. Cardiovascular disease is a significant complication in IPF patients due to the role of common proatherogenic immune mediators. The prevalence of coronary artery disease (CAD) in IPF and the association between these distinct pathologies with overlapping pathophysiology remain less studied.Research questionWe hypothesised that IPF is an independent risk factor for CAD.MethodsWe conducted a retrospective case–control study using the national inpatient sample (2017–2019). We included adult hospitalisations with IPF after excluding other interstitial lung diseases and other endpoints of CAD, acute coronary syndrome and old myocardial infarction. We examined their baseline characteristics, such as demographic data, hospital characteristics and socioeconomic status. The prevalence of cardiac risk factors and CAD was also compared between hospitalisations with and without IPF. Univariate and multivariate regression analysis was further performed to study the odds of CAD with IPF. The cases of IPF in the study population were propensity-matched, after which generalised linear modelling analysis was performed to validate the findings.ResultsA total of 116 010 admissions were hospitalised in 2017–2019 with IPF, of which 55.6% were men with a mean age of 73 years. Adult hospitalisations with IPF were found to have a higher prevalence of diabetes mellitus (29.3% vs 24.0%; p<0.001), hypertension (35.6% vs 33.8%; p<0.001), hyperlipidaemia (47.7% vs 30.2%; p<0.0001) and tobacco abuse (41.7% vs 20.9%; p<0.001), while they had a lower prevalence of obesity (11.7% vs 15.3%; p<0.0001) compared with hospitalisations without IPF. Multivariate logistic regression analysis revealed 28% higher odds of developing CAD in IPF hospitalisations (OR −1.28; CI 1.22 to 1.33; p<0.001). Postpropensity matching, generalised linear modelling analysis revealed even higher odds of CAD with IPF (OR −1.77; CI 1.54 to 2.02; p<0.001)ConclusionsOur study found a higher prevalence of CAD in IPF hospitalisations and significantly higher odds of CAD among IPF cases. IPF remains a terminal lung disease that portends a poor prognosis, but addressing the cardiovascular risk factors in these patients can help reduce the case fatality rate due to the latter and potentially add to quality-adjusted life years.

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“…Previous studies have suggested that fibrotic lung disorders predispose to coronary artery disease (CAD) (9,10). To the best of our knowledge, in the literature, we did not identify a study in which subclinical atherosclerosis was detail evaluated by cardiovascular risk tests in IPF patients.…”

Section: Introductionmentioning

confidence: 91%

İdiyopatik pulmoner fibrozisli hastalarda nabız dalga hızı, intima media kalınlığı ve akım aracılı dilatasyon ile kardiyovasküler risk değerlendirmesi

Altıntaş

Yüksel

Demirci

et al. 2023

Journal of Medicine and Palliative Care

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Aim: The underlying mechanism of fibrotic lung diseases predisposing to coronary artery disease is not yet clear. Chronic inflammation may contribute to atherosclerosis and play a role in increased cardiovascular risk. To study investigate subclinical atherosclerosis by measuring carotid femoral pulse wave velocity (PWV), carotid intima media thickness (CIMT), and flow-mediated dilatation (FMD) in patients with idiopathic pulmonary fibrosis (IPF). Material and Method: This cross-sectional study consisted of 55 newly diagnosed IPF patients and 55 healthy controls between September 2019 and September 2021. Cardiovascular Risk Assessment was evaluated by endothelial function measured by FMD, CIMT measured by carotid doppler ultrasonography, and arterial stiffness measured by PWV. Results: In multivariable regression models, the presence of IPF was common independent predictor of CIMT (β±SE=0.18±0.05, p=0.002), log(FMD) (β±SE=–0.15±0.04, p

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Idiopathic pulmonary fibrosis and coronary artery disease

Cited by 5 publications

References 19 publications

Exertional dyspnoea in interstitial lung diseases: the clinical utility of cardiopulmonary exercise testing

Exertional dyspnoea in interstitial lung diseases: the clinical utility of cardiopulmonary exercise testing

A Step towards understanding coronary artery disease: a complication in idiopathic pulmonary fibrosis

İdiyopatik pulmoner fibrozisli hastalarda nabız dalga hızı, intima media kalınlığı ve akım aracılı dilatasyon ile kardiyovasküler risk değerlendirmesi

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