{"title":"Lung function and exercise capacity in single ventricle patients post Fontan palliation and potential role of diaphragm ultrasound imaging","authors":"Paula Festa Cilveti, Chiara Marrone, Lamia Ait-Ali, Luca Bastiani, Ludovica Simonini, Claudio Passino, Francesca Mannucci, Alessandro Celi, Pierluigi Festa, Giosuè Catapano","doi":"10.1111/cpf.70063","DOIUrl":"10.1111/cpf.70063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Patients with Fontan circulation have reduced functional capacity, due to a reduced cardiac output, but also to an abnormal lung function and respiratory muscle weakness. This study aimed to assess lung function and exercise capacity in a cohort of patients with Fontan circulation and evaluate the prognostic impact of restrictive lung function (RLF). In addition, diaphragmatic ultrasound (DUS) investigated diaphragmatic function in a subgroup of patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with Fontan palliation who underwent lung function evaluation were included. A subgroup of patients additionally underwent DUS to assess diaphragmatic function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study population consisted of 53 post-Fontan patients (mean age 25 ± 10 years). Exercise capacity was reduced, with a median peak VO₂ of 18.4 mL/kg/min (IQR 14.7–22.6). Oxygen pulse was reduced and flattened, and ventilatory efficiency was impaired (mean VE/VCO₂ slope 36 ± 7), without evidence of mechanical ventilatory limitation. Spirometry revealed RLF in 48% of patients. RLF was associated with lower peripheral oxygen saturation, diuretic therapy use, and lower engagement in regular physical activity. Moreover, RLF was significantly associated with adverse events at follow-up (<i>χ</i>²: 6.8, <i>p</i> = 0.004). Diaphragm ultrasound (DUS), performed in 10 patients, showed abnormal function of at least one hemidiaphragm in most cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with Fontan circulation exhibit a markedly reduced exercise functional capacity resulting from a complex interplay between cardiac, pulmonary, and peripheral factors. Restrictive lung function was associated with increased need for diuretic therapy and lower levels of physical activity. Abnormal diaphragmatic function was frequently observed and may represent a potentially modifiable contributor to functional limitation warranting further investigation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"46 3","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Morten Bentestuen, Camilla Sylvest, Svend B. Jensen, Lara R. Soro, Aage Knudsen, Morten Ladekarl, Ole Thorlacius-Ussing, Wolfgang P. Fendler, Helle D. Zacho
{"title":"Safety of [68Ga]Ga-FAPI-46 PET/CT including hemodynamic measurements and patient-reported outcomes in cancer patients","authors":"Morten Bentestuen, Camilla Sylvest, Svend B. Jensen, Lara R. Soro, Aage Knudsen, Morten Ladekarl, Ole Thorlacius-Ussing, Wolfgang P. Fendler, Helle D. Zacho","doi":"10.1111/cpf.70064","DOIUrl":"10.1111/cpf.70064","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction Aim</h3>\u0000 \u0000 <p>Fibroblast activation protein inhibitor (FAPI) has demonstrated promising oncological diagnostic performance. Although no adverse events (AEs) have been previously reported, a formal safety evaluation of FAPI PET/CT is lacking. This study aimed to assess the safety and tolerability of [⁶⁸Ga]Ga-FAPI-46 PET/CT, with a focus on hemodynamic parameters, AEs, and patient-reported discomfort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Participants were included from two ongoing prospective diagnostic trials: (1) FAPI PET/CT in ovarian cancer (EU CTIS no. 2023-505938-98-00) and (2) FAPI PET/CT in gastric and gastroesophageal junction cancer (EU CTIS no. 2023-505916-40-01). A dose of 150–250 MBq [⁶⁸Ga]Ga-FAPI-46 was administered, and low-dose, non-contrast CT was performed. Hemodynamic parameters, including systolic and diastolic blood pressure (BP) and heart rate (HR), were measured at baseline, 1-min post-injection (p.i.), 10 min p.i., and post-scan. Additionally, potential AEs and discomfort were assessed at these timepoints and 1 day p.i., and participants were instructed to report events. AEs were graded according to the Common Terminology Criteria for Adverse Events version 5.0.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty participants were included. No patient reported AEs or discomfort attributable to [⁶⁸Ga]Ga-FAPI-46, and no significant changes in mean systolic or diastolic BP were observed; however, three patients experienced increases in systolic BP classified as AEs. A clinically non-relevant but statistically significant (<i>p</i> < 0.01) decrease in HR (from 77 bpm at baseline to 73 bpm at post-scan) was observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>[⁶⁸Ga]Ga-FAPI-46 PET/CT is well tolerated with no immediate patient-reported discomfort or clinically relevant hemodynamic AEs. The observed decrease in HR from baseline to post-scan likely reflects prescan nervousness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"46 3","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Structural heterogeneity of carotid, femoral and brachial arteries across the human lifespan: Normative data and reference intervals","authors":"Daniel Bia, Alejandro Diaz, Yanina Zócalo","doi":"10.1111/cpf.70062","DOIUrl":"10.1111/cpf.70062","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In physiological and pathological conditions arteries undergo changes in their structural characteristics (diastolic diameter (DD), diastolic cross-sectional area (DCSA), wall thickness, wall-to-lumen ratio). Accurate clinical use of arterial structural parameters (ASP) requires knowing their physiological age-related profiles and expected values for a specific subject. No studies have characterized the profiles of ASP in large populations jointly considering: (i) data from different age stages, (ii) arteries of different types (elastic, transitional, muscular) from both body sides and (iii) potential age-, sex-, and anthropometric-related differences. Additionally, (iv) there is a lack of normative data (reference intervals, RIs) for ASP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>(1) to determine the need for RIs differentiated by body side, sex, anthropometry and/or age; (2) to define RIs for ASP in a large cohort of healthy children, adolescents and adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Four-thousand three hundred seventy-one subjects (2–89 y) were considered, including 1927 (4–76 y) healthy and non-exposed to cardiovascular risk factors. Carotid, femoral and brachial ASP (DD, DCSA, intima-media thickness, wall-to-lumen ratio) were obtained (ultrasound). Association and agreement between the same parameter obtained from both sides (left/right) were analyzed (Concordance correlations, Bland–Altman test). Multivariate analyses allowed identifying whether RIs differentiated by age, sex and/or anthropometric characteristics were necessary. Mean and standard deviation equations, and sex-specific, body height (BH)- and age-related profiles were obtained (regression methods; fractional polynomials).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Physiological profiles and RIs were defined for ASP. The equations related to age, sex and BH obtained (and given) for the ASP would allow determining the expected values and potential deviations in a particular subject.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"46 3","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katalin Kiss, Aso Saeed, Sven-Erik Ricksten, Gudrun Bragadottir
{"title":"Clearance of mannitol for assessment of glomerular filtration rate in chronic kidney disease: A validation against iohexol clearance","authors":"Katalin Kiss, Aso Saeed, Sven-Erik Ricksten, Gudrun Bragadottir","doi":"10.1111/cpf.70059","DOIUrl":"10.1111/cpf.70059","url":null,"abstract":"<p>This study evaluates mannitol as a clearance marker for measuring glomerular filtration rate (GFR) in outpatients with chronic kidney disease (CKD). Multi-sample iohexol clearance served as the reference method. Twenty patients with CKD, stages 3–4, received bolus injections of both clearance markers simultaneously. Blood samples were collected 3, 5 and 22 h after the bolus injections. Marker concentrations were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS). A calculation template, based on the Bröchner–Mortensen multi-sample model, was applied to determine GFR for both markers. In addition, plasma clearance of mannitol was assessed using the one-sample Jacobsson equation, applied to samples taken 5 and 22 h after the bolus injection of mannitol. Agreement between the clearance methods was assessed by the Bland-Altman method, and the accuracy of mannitol clearance versus iohexol clearance was assessed by calculating P30 and P10. For the multi-sample clearance, the between-methods bias was 0.95 ± 1.4 mL/min/1.73 m², the error was 10%, and the accuracy was 100% for both P30 and P10. The corresponding values for bias, error, P30 and P10 for the one-sample plasma clearance of mannitol versus the reference method were: −2.3 ± 3.6 and 2.9 ± 3.0 mL/min/1.73 m², 24% and 21%, 95% and 100%, 80% and 60%, respectively for samples obtained 5 and 22 h after the bolus. Mannitol exhibited a reliable performance as a clearance marker in patients with CKD, stages 3–4, and may serve as an alternative when standard markers, iohexol or isotopes, are contraindicated. However, further large-scale studies are required to confirm these findings.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"46 3","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147607822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rie Skovly Thomsen, Clara Mikkelsen, Naja Enevold Olsen, Hrefna Sæunn Einarsdóttir, Mohamed Attauabi, Ronan M. G. Berg, Henrik Harboe, Jann Mortensen
{"title":"The effect of inhaled dry salt on pulmonary mucociliary clearance in obstructive lung disease: A randomised, placebo-controlled, crossover study","authors":"Rie Skovly Thomsen, Clara Mikkelsen, Naja Enevold Olsen, Hrefna Sæunn Einarsdóttir, Mohamed Attauabi, Ronan M. G. Berg, Henrik Harboe, Jann Mortensen","doi":"10.1111/cpf.70060","DOIUrl":"10.1111/cpf.70060","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Inhaled saline may improve mucus transport in respiratory diseases, for example, cystic fibrosis. This randomised, placebo-controlled, crossover study examined the effect of inhaled dry NaCl on mucociliary clearance in patients with chronic obstructive pulmonary disease (COPD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-five patients with GOLD stage I-III COPD (72% with excess mucus) were tested on two separate days after inhalation from a dry powder inhaler containing either 40 mg dry NaCl or placebo (empty). Pulmonary mucociliary clearance was assessed using inhalation of a radioactive <sup>99m</sup>Tc-labelled nanocolloid tracer and gamma camera imaging. Clearance was measured for 2 h post-intervention. Co-primary outcomes were clearance after 1 and 2 h.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study was terminated early due to COVID-19 after enrolling 25 of 35 planned patients. No significant differences were observed in mucociliary clearance between NaCl and placebo after 1 h (11.3% ± 9.0% vs. 11.4% ± 7.0%, <i>p</i> = 0.97) or 2 h (15.3% ± 9.8% vs.16.1% ± 8.7%, <i>p</i> = 0.55). Normalised clearance based on initial radioaerosol deposition also showed no difference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Inhalation of 40 mg dry NaCl was well tolerated without acute adverse effects in COPD patients. However, early termination left the study underpowered, increasing the risk of type II error. Non-significant findings should not be interpreted as evidence of no effect. Larger, adequately powered trials are needed to clarify the impact of dry NaCl inhalation on mucociliary clearance in COPD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"46 3","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13043247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Relationship between resting elasticity of quadriceps at multiple knee flexion angles and explosive athletic performance","authors":"Risa Adachi, Taiki Kodesho, Gakuto Nakao, Ginji Nara, Koki Ishiyama, Kazuyoshi Kozawa, Keita Sekiguchi, Takumi Kobayashi, Yoshinari Sakaki, Keigo Taniguchi","doi":"10.1111/cpf.70058","DOIUrl":"10.1111/cpf.70058","url":null,"abstract":"<p>We investigated the relationship between resting quadriceps elasticity at multiple knee flexion angles and explosive athletic performance. Thirty healthy men who exercised 4.8 ± 1.3 days/week for over a year participated. Resting muscle elasticity was assessed via shear modulus measurements of the rectus femoris (RF), vastus medialis, vastus lateralis (VL), and vastus intermedius at 0°, 30°, 60°, 90°, and 120° of knee flexion. Explosive performance was evaluated through rate of torque development (RTD), specifically RTD over the 50 ms interval (RTD50) and 100 ms interval (RTD100) from torque exertion onset. Other measures included countermovement jump (CMJ) height, and CMJ yielding and braking rates of force development (RFD). VL elasticity at 60° (<i>r</i> = 0.408, <i>p</i> = 0.025) and 120° (<i>r</i> = 0.420, <i>p</i> = 0.021) showed moderate positive correlations with RTD50. Similarly, VL elasticity at 60° (<i>r</i> = 0.432, <i>p</i> = 0.017), 90° (<i>r</i> = 0.370, <i>p</i> = 0.044), and 120° (<i>r</i> = 0.422, <i>p</i> = 0.020) showed moderate correlations with RTD100. Significant negative correlations were observed between CMJ height and RF elasticity at 120° (<i>r</i> = −0.407, <i>p</i> = 0.026) and VL elasticity at 90° (<i>r</i> = −0.368, <i>p</i> = 0.046). VL elasticity positively correlated with yielding RFD at 30° to 120° (<i>r</i> = 0.381-0.455, <i>p</i> ≤ 0.026) and with braking RFD at 0°, 30°, and 60° (<i>r</i> = 0.418-0.485, <i>p</i> ≤ 0.038). Overall, resting quadriceps elasticity—especially in the VL—was linked to components of RTD and RFD. Our results suggested that the resting elasticity of the quadriceps femoris, particularly of the VL, may influence RTD and the different stages of yielding and braking RFD that constitute CMJ performance. Thus, non-invasive muscle elasticity measurement at specific angles holds potential as a useful tool for evaluating explosive athletic performance.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"46 3","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}