Left ventricular diastolic dysfunction (LVDD) is prevalent in fibrotic ILD and independently associated with higher hazard for adverse outcomes including acute exacerbation, lung transplantation, or death, representing a potentially important treatable trait requiring multi-disciplinary care.
The prevalence of clinically relevant LVDD (echocardiographic grade 2 or 3) in the overall ILD cohort was 14%.
LVDD was independently associated with a higher hazard for a combined adverse outcome of acute exacerbation, lung transplantation, or death in the fibrotic ILD subgroup.
LVDD independently predicted increased all-cause mortality in fibrotic ILD patients.
LVDD was independently associated with reduced 6-minute walk distance in fibrotic ILD patients.
LVDD was associated with lower diffusing capacity for carbon monoxide (DLCO) in ILD patients.
The study prospectively characterized LVDD as a potential treatable trait in ILD, emphasizing its objective measurability and actionable treatment pathways.
This research suggests that a specific type of heart problem — called left ventricular diastolic dysfunction (LVDD), where the heart's main pumping chamber becomes stiff and does not fill with blood properly — is relatively common in patients with scarring lung disease (fibrotic interstitial lung disease, or ILD). Among 276 ILD patients studied over roughly three years, about 14% had this heart condition, and nearly all of those cases occurred in patients with the fibrotic (scarring) form of ILD rather than non-fibrotic forms. Patients with LVDD also had worse lung function as measured by a gas exchange test and were less able to walk long distances. The study found that patients with fibrotic ILD who also had LVDD were significantly more likely to experience serious health events — including disease flare-ups (acute exacerbations), need for a lung transplant, or death — compared to those without LVDD. Specifically, their risk of these combined bad outcomes was roughly 1.8 to 2 times higher, even after accounting for other health differences between patients. Their risk of death from any cause was also about twice as high. These associations held up even when the researchers used statistical techniques to make the comparison groups more similar to each other. This research suggests that routinely checking ILD patients for LVDD using heart ultrasound (echocardiography) could be clinically important, since LVDD can be identified with standard tests and there are existing treatments for it. The authors propose that LVDD should be considered a 'treatable trait' in ILD — meaning it is a specific, measurable condition that could be targeted to improve patient outcomes — and that managing it likely requires coordination between lung specialists and heart specialists.
Freund O, Katsoff U, Hershko T, Ron A, Frydman S, Cohn-Schwartz D, et al.. (2026). Left Ventricular Diastolic Dysfunction in Patients with Interstitial Lung Disease-A Potential Treatable Trait.. Advances in respiratory medicine. https://doi.org/10.3390/arm94040057