Key result
LV diastolic dysfunction is linked to ~82% higher risk of adverse outcomes in fibrotic ILD.
Why the study?
Cardiovascular comorbidities complicate interstitial lung disease, but the prevalence and clinical impact of left ventricular diastolic dysfunction remain poorly characterized.
Does left ventricular diastolic dysfunction predict adverse clinical outcomes in patients with interstitial lung disease?
Observational (n=276)
No
Does left ventricular diastolic dysfunction predict adverse clinical outcomes in patients with interstitial lung disease?
Hazard Ratio: 1.82 (95% CI 1.03–3.38)
Absolute Event Rate: 41% vs 22%
p-value: p=0.043
Clinically relevant left ventricular diastolic dysfunction is prevalent in fibrotic interstitial lung disease and independently predicts increased mortality and adverse clinical outcomes, highlighting it as a potential treatable trait.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“I would like to congratulate the authors for this well-conducted prospective study addressing an important and clinically relevant topic. The manuscript is clearly written, the study design is appropriate, and the statistical methodology—including multivariable analyses and propensity score matching—strengthens the validity of the findings. The concept of left ventricular diastolic dysfunction (LVDD) as a potentially treatable trait in patients with interstitial lung disease (ILD) is original and clinically meaningful, with potential implications for multidisciplinary patient management.”
LVDD may flag higher-risk fibrotic ILD patients; leaves open whether treating diastolic dysfunction improves outcomes.
Cardiovascular comorbidities complicate interstitial lung disease (ILD) and represent potential therapeutic targets, yet the prevalence and clinical impact of left ventricular diastolic dysfunction (LVDD) remain poorly characterized. We aimed to evaluate LVDD as a potential treatable trait within a prospective cohort. Using data from an ILD registry (January 2021–October 2024), we defined clinically relevant LVDD as echocardiographic grade 2 or 3 diastolic dysfunction. Out of 276 patients (median age 69, 44% female), 14% had LVDD, which was almost entirely in patients with fibrosis (97%, p = 0.045) and associated with lower diffusing capacity for carbon monoxide. Survival and clinical analyses restricted to the fibrotic ILD subgroup (n = 241) showed that LVDD was independently associated with a higher hazard for a combined adverse outcome of acute exacerbation, lung transplantation, or death (adjusted HR 1.82, 95% CI 1.03–3.38, p = 0.043), which persisted after 1:2 propensity score matching (HR 2.04). LVDD also independently predicted increased all-cause mortality (adjusted HR 2.10) and reduced 6-minute walk distance (median 413 vs. 465 m, β= −0.14, p = 0.036). In conclusion, LVDD is prevalent in fibrotic ILD and carries significant prognostic implications. Given its objective measurability and actionable treatment pathways, LVDD represents a potentially important treatable trait requiring multi-disciplinary care.
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Freund et al. (2026) conducted an observational in Interstitial lung disease (n=276). Left ventricular diastolic dysfunction (LVDD) vs. No left ventricular diastolic dysfunction was evaluated on Combined outcome of ILD acute exacerbations, lung transplantation, and death in patients with fibrotic ILD (HR 1.82, 95% CI 1.03-3.38, p=0.043). In patients with fibrotic interstitial lung disease, left ventricular diastolic dysfunction was independently associated with a higher hazard for the combined outcome of acute exacerbation, lung transplantation, or death (HR 1.82).
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