Impact of Inflammatory Bowel Disease on Pulmonary Hemodynamics and Right Ventricular Function: The Role of Pulmonary Pulse Transit Time in Assessing Pulmonary Stiffness and Right Ventricular Function

Aim: Inflammatory bowel disease (IBD) is a chronic disease with systemic implications, including cardiovascular effects. The aim of this study was to investigate the impact of IBD on right ventricular (RV) function and pulmonary hemodynamics, focusing on the relationship between pulmonary pulse transit time (pPTT) and other echocardiographic markers. Material and Methods: Fifty IBD patients and 50 matched healthy controls underwent echocardiographic evaluation to assess RV function, including parameters such as RV myocardial performance index (RVMPI), RV ejection fraction (RV EF) and tricuspid annular plane systolic excursion (TAPSE). Pulmonary hemodynamics were assessed by pPTT and pulmonary arterial stiffness (PAS). Statistical analyses explored the associations between IBD and these echocardiographic parameters. Results: No differences in systolic pulmonary artery pressure (sPAP) or TAPSE were observed between the groups. PAS was increased and pPTT was shortened in IBD patients compared to controls. pPTT correlated with PAS, IBD duration, RV EF, RV fractional area change (RVFAC), TAPSE, tricuspid S', RVMPI and C-reactive protein (CRP). pPTT was an independent predictor of PAS (p < 0.001). Conclusion: IBD patients show impaired RV function and increased pulmonary stiffness. pPTT may serve as a practical marker for early detection of pulmonary vascular changes in IBD, replacing PAS for hemodynamic assessment.