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Impact of Interstitial Lung Disease on Left Ventricular Myocardial Function

Max Jonathan Stumpf, Marina Michaela Luise Wirtz, Max Fabian Fleddermann, Leonie Biener, Leonie Weinhold, Marcel Weber, Christian Alexander Schaefer, Georg Nickenig, Dirk Skowasch, Carmen Pizarro


Interstitial lung disease (ILD) comprises a wide variety of pulmonary parenchymal disorders within which progressive fibrosing ILD (PF-ILD) constitutes a phenotypic subset. By use of speckle tracking-based strain analysis we aimed to evaluate the degree of left ventricular (LV) dysfunction in progressive vs. non-progressive fibrosing ILD (non-PF-ILD).


Interstitial lung disease (ILD) encompasses a large group of more than 200 parenchymal lung disorders that share similar clinical, radiological and pathophysiological characteristics [1]. A proportion of ILD patients may develop a progressive fibrotic phenotype. A consented definition on progressive fibrosing ILD (PF-ILD) was provided by the INBUILD study [2]. Progression was defined by clearly specified combinations of worsening in pulmonary function, respiratory symptomatology and high-resolution computed tomography (HRCT) over the preceding 24 months despite treatment.

Materials and method

Between December 2018 and November 2020, a total of 104 patients aged ≥ 18 years receiving treatment for ILD at the outpatient Department of Pneumology, University Hospital Bonn (Bonn, Germany), were screened for this prospective cohort study. Five patients were excluded due to either acute exacerbated ILD at the time of evaluation or their denial to undergo cardiac diagnostics. ILD- diagnosis relied on consensus by multidisciplinary discussion. Differentiation between PF-ILD and non-PF-ILD was based on the INBUILD study criteria [2]. PF-ILD was defined by at least one of the following criteria, fulfilled within 24 months, despite standard treatment: a) relative decline in forced vital capacity (FVC) ≥ 10% predicted, b) relative decline in FVC ≥ 5–10% predicted and worsened respiratory or increased extent of fibrosis on HRCT, or c) worsened respiratory symptoms and increased extent of fibrosis on HRCT.


Demographic characteristics and clinical data of the study population are given in Table 1. 50 out of 99 ILD patients met the PF-ILD criteria, 49 patients exhibited a non-PF-ILD. The underlying ILD aetiology differed significantly between both patient groups. Within the PF-ILD cohort, IPF was present in half of the cases (n = 25, 50.0%), followed by ILD due to autoimmune diseases (n = 9, 18.0%). In non-PF-ILD, stage IV sarcoidosis and autoimmune ILD equally constituted the most common underlying ILD types, each with n = 15 (30.6%).


In the present study, we aimed to determine LV function by speckle tracking-based strain analysis as a function of progressive versus non-progressive fibrosing ILD.

Citation: Stumpf MJ, Wirtz MML, Fleddermann MF, Biener L, Weinhold L, Weber M, et al. (2024) Impact of interstitial lung disease on left ventricular myocardial function. PLoS ONE 19(2): e0286423.

Editor: Vincenzo Lionetti, Scuola Superiore Sant’Anna, ITALY

Received: January 21, 2023; Accepted: May 16, 2023; Published: February 6, 2024

Copyright: © 2024 Stumpf et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper and its Supporting information files.

Funding: The authors received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.


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