Prevalence of hiatal hernia by blinded multidetector CT in patients with idiopathic pulmonary fibrosis Journal Article

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Authors: Noth, I.; Zangan, S. M.; Soares, R. V.; Forsythe, A.; Demchuk, C.; Takahashi, S. M.; Patel, S. B.; Strek, M. E.; Krishnan, J. A.; Patti, M. G.; MacMahon, H.
Article Title: Prevalence of hiatal hernia by blinded multidetector CT in patients with idiopathic pulmonary fibrosis
Abstract: Hiatal hernia (HH) is associated with gastro-oesophageal reflux (GOR) and/or GOR disease and may contribute to idiopathic pulmonary fibrosis (IPF). We hypothesised that HH evaluated by computed tomography is more common in IPF than in asthma or chronic obstructive pulmonary disease (COPD), and correlates with abnormal GOR measured by pH probe testing. Rates of HH were compared in three cohorts, IPF (n=100), COPD (n=60) and asthma (n=24), and evaluated for inter-observer agreement. In IPF, symptoms and anti-reflux medications were correlated with diffusing capacity of the lung for carbon monoxide (D(L,CO)) and composite physiologic index (CPI). HH was correlated with pH probe testing in IPF patients (n=14). HH was higher in IPF (39%) than either COPD (13.3%, p=0.00009) or asthma (16.67%, p=0.0139). The HH inter-observer kappa agreement was substantial in IPF (kappa=0.78) and asthma (kappa=0.86), and moderate in COPD (kappa=0.42). In IPF, HH did not correlate with lung function, except in those on anti-reflux therapy, who had a better D(L,CO) (p0.03) and CPI (p0.04). HH correlated with GOR as measured by DeMeester scores (p0.04). HH is more common in IPF than COPD or asthma. In an IPF cohort, HH correlated with higher DeMeester scores, confirming abnormal acid GOR. Presence of HH alone was not associated with decreased lung function.
Journal Title: The European respiratory journal
Volume: 39
Issue: 2
ISSN: 1399-3003; 0903-1936
Publisher: Unknown  
Journal Place: Switzerland
Date Published: 2012
Start Page: 344
End Page: 351
Language: eng
DOI/URL:

10.1183/09031936.00099910
Notes: LR: 20140408; GR: U10HL080513/HL/NHLBI NIH HHS/United States; JID: 8803460; CIN: Eur Respir J. 2012 Feb;39(2):242-5. PMID: 22298612; 2011/07/07 [aheadofprint]; ppublish