No data are actually available regarding the left atrial (LA) functional assessment by two-dimensional speckle tracking echocardiography (2D-STE) in early-stage idiopathic pulmonary fibrosis (IPF). The primary end-point of our study was to assess whether global LA peak strain (GLAPS), measured by 2D-STE analysis, may detect early alterations in LA function in IPF patients without right heart failure (RHF). Between September 2017 and January 2019, 50 consecutive IPF patients (73.8 ± 6.8 years, 36 males) without chronic RHF and 30 controls matched by age, sex and cardiovascular risk factors, were enrolled in an observational retrospective case–control study. All patients underwent a complete echocardiographic study implemented with 2D-STE analysis. GLAPS, left ventricular (LV) global longitudinal strain (GLS), right atrial (RA) reservoir strain (GSA+) and right ventricular (RV)-GLS were obtained in each patient. LVFP were significantly increased in IPF patients in comparison to controls (average E/e′ ratio 14.4 ± 3.0 vs 9.6 ± 1.5, p < 0.0001), while LV-GLS was slightly reduced in IPF patients compared to controls (19.4 ± 3.6% vs 21.0 ± 2.2%, p = 0.03).Moreover, GLAPS was significantly impaired in IPF patients in comparison to controls (18.4 ± 3.7% vs 28.4 ± 5.6%, p < 0.0001).Finally, the two groups of patients did not show any statistically significant difference in both RA-GSA + (23.9 ± 3.7% vs 24.5 ± 4.0%, p = 0.49) and RV-GLS (− 22.6 ± 3.3% vs − 23.5 ± 3.0%, p = 0.22). Notably, LV-GLS was strongly inversely correlated both with RV/LV basal diameter ratio and TRV in IPF patients (r = − 0.87 and − 0.82, respectively) but not in controls (r = − 0.29 and − 0.27, respectively). This finding highlights a likely process of ventricular interdependence in non-advanced IPF, with consequent LV diastolic dysfunction and secondary impairment in LV-GLS and GLAPS. Early LA reservoir dysfunction in IPF patients may be secondary to LV diastolic dysfunction induced by ventricular interdependence and may develop before RV diastolic and systolic dysfunction.

对于早期特发性肺纤维化（IPF）的二维斑点跟踪超声心动图（2D-STE），实际上尚无关于左心房（LA）功能评估的数据。我们研究的主要终点是评估通过2D-STE分析测量的整体LA峰值应变（GLAPS）是否可以检测出无右心衰竭（RHF）的IPF患者的LA功能的早期改变。在2017年9月至2019年1月之间，连续进行了50例无慢性RHF的IPF患者（73.8±6.8岁，男36例），并有30例年龄，性别和心血管危险因素匹配的对照者参加了一项观察性回顾性病例对照研究。所有患者均接受了通过2D-STE分析实施的完整超声心动图研究。GLAPS，左心室（LV）整体纵向应变（GLS），每例患者均获得了右心房（RA）储库株（GSA +）和右心室（RV）-GLS。与对照组相比，IPF患者的LVFP显着增加（平均E / e'比14.4±3.0 vs 9.6±1.5，p <0.0001），而与对照组相比，IPF患者的LV-GLS略有降低（19.4±3.6％vs 21.0±2.2％，p = 0.03）。此外，与对照组相比，IPF患者的GLAPS明显受损（18.4±3.7％vs 28.4±5.6％，p <0.0001）。最后，两组患者均未显示RA-GSA +（23.9±3.7％vs 24.5±4.0％，p = 0.49）和RV-GLS（− 22.6±3.3％vs-23.5±3.0％，p = 0.22）均具有统计学显着性差异。值得注意的是，在IPF患者中LV-GLS与RV / LV基础直径比和TRV呈极显着负相关（分别为r = − 0.87和− 0.82），而在对照组中则没有（r = − 0）。29和-0.27）。这一发现突显了非晚期IPF的心室相互依赖性的可能过程，随之而来的是LV舒张功能障碍和LV-GLS和GLAPS的继发性损伤。IPF患者的早期LA储库功能障碍可能继发于心室相互依赖性诱发的LV舒张功能障碍，并可能在RV舒张功能和收缩功能障碍之前发展。