Abstract
Responses to Pirfenidone Treatment in Patients with Idiopathic Pulmonary Fibrosis is Not Associated with Changes in Echocardiographic Parameters of Left Ventricular Structure and Function
Journal of cardiac failure, Vol.25(8), pp.S27-S27
08/2019
DOI: 10.1016/j.cardfail.2019.07.074
Abstract
Pirfenidone, an FDA-approved novel anti-fibrotic agent used in the treatment of idiopathic pulmonary fibrosis (IPF), has been implicated in mitigating myocardial fibrosis, systolic and diastolic dysfunction in animal models (Kuwahara et al, Circulation 2002). However to date, the effect of Pirfenidone on left ventricular (LV) structure and function in humans with IPF has not been studied.
We hypothesize that changes in echocardiographic parameters of LV structure and function would be more favorable in responders compared to non-responders of pirfenidone in patients with IPF.
We performed a retrospective review of 27 consecutive patients with IPF on pirfenidone between 2014-2018 with serial baseline and follow up echocardiograms and pulmonary function testing. Treatment failure (non-response) was defined as an absolute decline in forced vital capacity (FVC) of more than 10% whilst being on the medication. Comprehensive echocardiographic data extraction and analysis was performed in all patients. Changes in parameters of LV structure (LV mass, interventricular septal and posterior wall thickness, indexed end systolic and diastolic volumes), systolic function (LVEF), diastolic function (Indexed left atrial volume, trans-mitral Doppler flow patterns, tissue Doppler indices) and global LV longitudinal strain were compared between responders and non-responders.
In our study cohort, 18 responders and 9 non-responders were identified. Responders were significantly older than non-responders, yet sex, history of CAD, hypertension, diabetes, atrial fibrillation, CKD and cardiac medication use were not significantly different. Baseline echocardiographic parameters were comparable, except for septal e/e’, which was higher in responders (11.68 vs 10.1; p<0.01). After treatment, no significant differences in changes of echocardiographic parameters of LV structure, diastolic function, systolic function and GLS were observed between responders and non-responders of pirfenidone (all p=NS).
In contrary to our hypothesis, we observed that response to pirfenidone therapy in patients with IPF did not associate with echocardiographic changes of left ventricle structure and function.
Details
- Title: Subtitle
- Responses to Pirfenidone Treatment in Patients with Idiopathic Pulmonary Fibrosis is Not Associated with Changes in Echocardiographic Parameters of Left Ventricular Structure and Function
- Creators
- Shehab AlAnsariBrian SouthernHaris RiazVikram SharmaAllen BorowskiW.H. Wilson Tang
- Resource Type
- Abstract
- Publication Details
- Journal of cardiac failure, Vol.25(8), pp.S27-S27
- Publisher
- Elsevier Inc; PHILADELPHIA
- DOI
- 10.1016/j.cardfail.2019.07.074
- ISSN
- 1071-9164
- eISSN
- 1532-8414
- Language
- English
- Date published
- 08/2019
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984808210802771
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