Idiopathic pulmonary fibrosis and coronary artery disease

Idiopathic pulmonary fibrosis (IPF) is defined as a chronic fibrosing interstitial disease of unknown cause, limited to the lungs and associated with the histopathologic and/or radiologic pattern of usual interstitial pneumonia (UIP); it generally evolves into respiratory failure and death. Although progression of the disease is the most common cause of death, a growing incidence of other pathologies has been reported: e.g. IPF patients seem more susceptible to cardiovascular diseases. Therefore, also other pathologies might influence the natural course. In this paper we describe a case of IPF and coronary artery disease (CAD). We emphasize the importance of cardiopulmonary exercise test (CPET) as a useful procedure to monitor disease progression in IPF patients. We also stress the necessity of a careful analysis of variables measured for an accurate interpretation of the clinical picture and an improvement of the clinical management of patients. Moreover, we suggest that a careful assessment of CPET parameters may additionally help in early detection of high cardiovascular ischemic risk.