Extrinsic causes of restrictive lung syndrome in idiopathic pulmonary fibrosis (IPF) patients have been poorly investigated. We aimed to investigate the influence of the anterior chest wall deformity, noninvasively assessed by modified Haller index (MHI), on spirometry parameters and outcome in a consecutive population of patients with mild-to-moderate IPF. Sixty consecutive IPF patients (73.8 +/- 6.6 years, 45 males) were included in this retrospective study. All patients underwent physical examination, spirometry, blood tests, conventional transthoracic echocardiography and MHI assessment (chest transverse diameter over the distance between sternum and spine) at basal evaluation. During follow-up, we evaluated the composite endpoint of (1) pulmonary or cardiovascular hospitalizations and (2) all-cause mortality. IPF patients with concave-shaped chest wall (MHI > 2.5) (36.7% of total) and those with normal chest shape (MHI <= 2.5) (63.3%) were separately analyzed. In comparison to IPF patients with MHI <= 2.5, those with MHI > 2.5: were less likely to be men and smokers; had a more severe restrictive pattern; had significantly smaller cardiac chamber dimensions and significantly higher systolic pulmonary artery pressure (51.9 +/- 15.1 vs 42.4 +/- 14.3 mmHg, p = 0.02). Mean follow-up time was 2.5 +/- 1.4 years. During follow-up, 13 deaths and 16 pulmonary or cardiovascular hospitalizations were detected. At multivariate Cox regression analysis, concave-shaped chest wall (MHI > 2.5) (HR 4.55, 95% CI 1.02-20.4), increased C-reactive protein (HR 1.68, 95% CI 1.08-2.61) and absence of beta-blocker therapy (HR 0.13, 95% CI 0.01-0.26) were independently associated to the investigated outcome. MHI assessment and implementation may help the clinician to identify, among IPF patients, those with poorer prognosis over a medium-term follow-up.

Influence of chest wall conformation on spirometry parameters and outcome in mild-to-moderate idiopathic pulmonary fibrosis / A. Sonaglioni, A. Caminati, G.L. Nicolosi, M. Lombardo, S. Harari. - In: INTERNAL AND EMERGENCY MEDICINE. - ISSN 1828-0447. - 17:4(2022 Jun), pp. 989-999. [10.1007/s11739-021-02889-4]

Influence of chest wall conformation on spirometry parameters and outcome in mild-to-moderate idiopathic pulmonary fibrosis

M. Lombardo
Penultimo
;
S. Harari
Ultimo
2022

Abstract

Extrinsic causes of restrictive lung syndrome in idiopathic pulmonary fibrosis (IPF) patients have been poorly investigated. We aimed to investigate the influence of the anterior chest wall deformity, noninvasively assessed by modified Haller index (MHI), on spirometry parameters and outcome in a consecutive population of patients with mild-to-moderate IPF. Sixty consecutive IPF patients (73.8 +/- 6.6 years, 45 males) were included in this retrospective study. All patients underwent physical examination, spirometry, blood tests, conventional transthoracic echocardiography and MHI assessment (chest transverse diameter over the distance between sternum and spine) at basal evaluation. During follow-up, we evaluated the composite endpoint of (1) pulmonary or cardiovascular hospitalizations and (2) all-cause mortality. IPF patients with concave-shaped chest wall (MHI > 2.5) (36.7% of total) and those with normal chest shape (MHI <= 2.5) (63.3%) were separately analyzed. In comparison to IPF patients with MHI <= 2.5, those with MHI > 2.5: were less likely to be men and smokers; had a more severe restrictive pattern; had significantly smaller cardiac chamber dimensions and significantly higher systolic pulmonary artery pressure (51.9 +/- 15.1 vs 42.4 +/- 14.3 mmHg, p = 0.02). Mean follow-up time was 2.5 +/- 1.4 years. During follow-up, 13 deaths and 16 pulmonary or cardiovascular hospitalizations were detected. At multivariate Cox regression analysis, concave-shaped chest wall (MHI > 2.5) (HR 4.55, 95% CI 1.02-20.4), increased C-reactive protein (HR 1.68, 95% CI 1.08-2.61) and absence of beta-blocker therapy (HR 0.13, 95% CI 0.01-0.26) were independently associated to the investigated outcome. MHI assessment and implementation may help the clinician to identify, among IPF patients, those with poorer prognosis over a medium-term follow-up.
Idiopathic pulmonary fibrosis; Modified Haller index; Outcome; Restrictive lung disease; Spirometry
Settore MED/10 - Malattie dell'Apparato Respiratorio
giu-2022
Article (author)
File in questo prodotto:
Non ci sono file associati a questo prodotto.
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/953174
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 1
  • ???jsp.display-item.citation.isi??? 1
social impact