COPD: Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"Dynamic Assessment of Exercise Gas Exchange Efficiency by Breath-by-Breath Volumetric Capnography in Mild-Moderate COPD.","authors":"Matthew D James, John McCleary, Guilherme D Back, Karam A Alosta, Reginald M Smyth, Sandra G Vincent, Chu-Yi Wang, Nicolle J Domnik, Audrey Borghi-Silva, William Stringer, Janos Porszasz, Denis E O'Donnell, J Alberto Neder","doi":"10.1080/15412555.2026.2650696","DOIUrl":"https://doi.org/10.1080/15412555.2026.2650696","url":null,"abstract":"<p><p>A sizable fraction of dyspneic patients with only mild to moderate COPD exhibit a heightened ventilatory response to exercise relative to metabolic demands, i.e. a high ventilation (<math><mrow><mover><mi>V</mi><mo>.</mo></mover></mrow></math>_E)/CO₂ output (<math><mrow><mover><mi>V</mi><mo>.</mo></mover></mrow></math>CO₂). The lack of continuous assessment of gas exchange efficiency and estimates of arterial CO₂ partial pressure has hindered our understanding of the physiological underpinnings of this dynamic phenomenon. We compared key indices of gas exchange efficiency relative to the intra-breath CO₂ profile as a function of expired volume using breath-by-breath volumetric capnography in 30 patients (FEV₁ = 76 ± 17%) and 30 sex- and age-matched controls during incremental cycle ergometry. Wasted ventilation in the physiological dead space (V_D_phys) was calculated as the sum of airway and alveolar (_alv) dead space divided by tidal volume (V_T). Transcutaneous (_tc) readings provided estimates of arterialised PCO₂. Patients exhibited lower exercise tolerance, reporting higher dyspnoea throughout exercise (<i>p</i> < 0.05). Higher <math><mrow><mover><mi>V</mi><mo>.</mo></mover></mrow></math>_E/<math><mrow><mover><mi>V</mi><mo>.</mo></mover></mrow></math>CO₂ was associated with higher absolute (L) alveolar dead space (V_D_alv), but similar V_T; thus, both V_D_phys/V_T and V_D_alv/V_T were consistently higher in patients (<i>p</i> < 0.05). <math><mrow><mover><mi>V</mi><mo>.</mo></mover></mrow></math>_E/<math><mrow><mover><mi>V</mi><mo>.</mo></mover></mrow></math>CO₂ was elevated (≥34) in normocapnic patients (P_tcCO₂≥35 mmHg) who had a high V_Dphys/V_T (≥0.3); conversely, high <math><mrow><mover><mi>V</mi><mo>.</mo></mover></mrow></math>_E/<math><mrow><mover><mi>V</mi><mo>.</mo></mover></mrow></math>CO₂ coexisted with a lower V_D_phys/V_T only in hypocapnic subjects (<i>p</i> < 0.05). Higher V_D_alv and lower P_tcCO₂ were independently associated with a high <math><mrow><mover><mi>V</mi><mo>.</mo></mover></mrow></math>_E/<math><mrow><mover><mi>V</mi><mo>.</mo></mover></mrow></math>CO₂ nadir and iso-work rate dyspnoea (<i>p</i> < 0.001). Based on this innovative, high-density data-acquisition approach, we conclude that both wasted ventilation and alveolar hyperventilation, in a highly variable combination, contribute to excessive ventilation in dyspneic patients with mild-to-moderate COPD.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2650696"},"PeriodicalIF":2.8,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411038","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}

{"title":"Authors' Reply to Saini et al.: The Role of Real-World Data in Optimizing COPD Rehabilitation.","authors":"Chigusa Shirakawa, Akihiro Shiroshita, Chisato Miyakoshi, Kazuaki Uda, Kazuma Nagata, Ryo Tachikawa, Keisuke Tomii, Yuki Kataoka","doi":"10.1080/15412555.2026.2635724","DOIUrl":"https://doi.org/10.1080/15412555.2026.2635724","url":null,"abstract":"","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2635724"},"PeriodicalIF":2.1,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343920","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}

{"title":"Comment on \"Early Post-Discharge Predictors of Sedentary Behaviour Following COPD Exacerbation: an Observational Study\".","authors":"Shanvi Priya, Mousumi Saha, Subhasish Chatterjee, Shivi Bajpai","doi":"10.1080/15412555.2026.2631252","DOIUrl":"https://doi.org/10.1080/15412555.2026.2631252","url":null,"abstract":"","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2631252"},"PeriodicalIF":2.1,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147376333","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}

{"title":"Letter to the Editor-Early Post-DischSarge Predictors of Sedentary Behavior Following COPD Exacerbation.","authors":"Debarghya Sen, Suman Pradhan, Mousumi Saha, Subhasish Chatterjee","doi":"10.1080/15412555.2026.2629544","DOIUrl":"10.1080/15412555.2026.2629544","url":null,"abstract":"","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2629544"},"PeriodicalIF":2.8,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212412","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}

{"title":"Integrating Lung Function Parameters into the Framingham Score for Improved CVD Risk Prediction in COPD: A Cross-Sectional Study Based on NHANES 2007-2012.","authors":"Haifeng Liu, An-Guo Chen","doi":"10.1080/15412555.2026.2628586","DOIUrl":"10.1080/15412555.2026.2628586","url":null,"abstract":"<p><p>Individuals with Chronic Obstructive Pulmonary Disease (COPD) constitute a high-risk population for Cardiovascular Disease (CVD). There is growing concern that standard risk assessment tools like the Framingham Risk Score (FRS) may be subject to underestimation of CVD risk in COPD patients. Therefore, the potential of combining lung function parameters with the FRS to improve risk prediction warrants further exploration. To determine whether the integration of lung function parameters with the Framingham Risk Score enhances the prediction of prevalent cardiovascular disease among individuals with COPD. We performed a cross-sectional analysis of adults with COPD from the 2007-2012 NHANES cycles. COPD was defined as a post-bronchodilator FEV₁/FVC < 0.70 or a self-reported physician diagnosis of emphysema or chronic bronchitis. Cardiovascular disease (CVD) was defined as a self-reported history of coronary heart disease, congestive heart failure, heart attack, or angina. The primary predictors were the Framingham Risk Score (FRS) and multiple spirometric parameters, including FEV₁, FVC, FEV₁%pred, FVC%pred and FEV₁/FVC. The FRS, which estimates an individual's 10-year risk of developing CVD, was calculated using the established algorithm that incorporates sex, age, total and high-density lipoprotein (HDL) cholesterol levels, systolic blood pressure, antihypertensive medication use, smoking status, and diabetes status. We used multivariable logistic regression to assess their association with prevalent CVD. Model discrimination was evaluated using the area under the receiver operating characteristic curve (AUC), and the incremental value of adding lung function parameters to the FRS was formally tested with DeLong's test. Subgroup analyses were conducted to test the consistency of the main findings across different demographic and clinical strata. The integration of lung function parameters with the Framingham Risk Score (FRS) improved predictive discrimination. The AUC for the FRS-alone model was 0.646. This increased to 0.681 for FRS + FEV₁%pred, 0.702 for FRS + FVC%pred, and 0.724 for FRS + FEV₁/FVC. The addition of each spirometric measure provided statistically significant incremental value over the FRS alone (all *p* < 0.01 by DeLong's test), with the greatest improvement observed for the FEV₁/FVC.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2628586"},"PeriodicalIF":2.8,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343972","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}

{"title":"Letter to the Editor: Pulmonary Hypertension as a Determinant of In-Hospital Mortality in COPD: Insights and Methodological Considerations.","authors":"Anchal Thakur, Anchal Thakur, Kanika Bhatia","doi":"10.1080/15412555.2026.2621733","DOIUrl":"10.1080/15412555.2026.2621733","url":null,"abstract":"","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2621733"},"PeriodicalIF":2.8,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149445","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}

{"title":"GOLD 2026 Report: What is New and What is Noteworthy for the Practicing Clinician.","authors":"Georgios Hillas, Athena Gogali, Stelios Loukides, Konstantinos Kostikas","doi":"10.1080/15412555.2026.2622744","DOIUrl":"https://doi.org/10.1080/15412555.2026.2622744","url":null,"abstract":"","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2622744"},"PeriodicalIF":2.1,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343976","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}

{"title":"Initial Treatment of COPD with LABA-LAMA Versus LAMA: Real-World Comparative Effectiveness and Safety.","authors":"Samy Suissa, Mathew Cherian, Sophie Dell'Aniello, Pierre Ernst","doi":"10.1080/15412555.2026.2622739","DOIUrl":"10.1080/15412555.2026.2622739","url":null,"abstract":"<p><p>Respiratory societies now advocate for long-acting beta₂-agonist (LABA) and long-acting muscarinic antagonist (LAMA) combinations (LABA-LAMA) as initial pharmacological treatment of COPD patients with multiple exacerbations or significant symptoms. However, the evidence comes from trials involving treatment-experienced patients. We identified a cohort of newly diagnosed COPD patients, 40 years of age or older, from the UK's Clinical Practice Research Datalink over 2014-2021. Treatment-naïve initiators of single-inhaler LABA-LAMA or LAMA were compared on the incidence of COPD exacerbation and major adverse cardiovascular events (MACE) over one year, after adjustment by propensity score weighting. The cohort included 16,804 initiators of LABA-LAMA and 57,295 of LAMA. The adjusted hazard ratio (HR) of a first moderate or severe exacerbation with LABA-LAMA relative to LAMA was 1.00 (95% confidence interval (CI): 0.96-1.05). This HR was 0.93 (95% CI: 0.86-1.00) among GOLD group E patients, 1.07 (95% CI: 0.99-1.15) among GOLD group B patients, and 0.91 (95% CI: 0.83-0.99) for patients with FEV₁ < 50% predicted. The HR of MACE was 1.13 (95% CI: 1.02-1.25) overall and 1.03 (95% CI: 0.83-1.28) among patients with FEV₁ < 50% predicted. In a real-world clinical practice setting of COPD treatment, initiating therapy with LABA-LAMA may be more effective at exacerbation reduction than LAMA among patients with multiple exacerbations and those with FEV₁<50% predicted. The small increase in MACE risk with LABA-LAMA should be considered when initiating bronchodilator therapy in newly diagnosed COPD, particularly those with FEV₁≥50% predicted. This study supports a targeted approach to initial COPD therapy.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2622739"},"PeriodicalIF":2.8,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218908","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}

{"title":"Pharmacologic Treatment of COPD: Disparities Between Evidence and Recommendations in GOLD 2023/4.","authors":"Samy Suissa","doi":"10.1080/15412555.2025.2517622","DOIUrl":"https://doi.org/10.1080/15412555.2025.2517622","url":null,"abstract":"","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"22 1","pages":"2517622"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324690","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}

{"title":"Phase-Resolved Functional Lung MRI Evaluation of Dynamic Hyperinflation Induced by Metronome-Paced Tachypnea in Patients with Chronic Obstructive Pulmonary Disease.","authors":"R A Müller, F Klimeš, A Voskrebenzev, L Behrendt, T F Kaireit, M Wernz, M Zubke, A L Kern, M R Prince, W Shen, C B Cooper, R G Barr, J M Hohlfeld, J Vogel-Claussen","doi":"10.1080/15412555.2025.2502671","DOIUrl":"10.1080/15412555.2025.2502671","url":null,"abstract":"<p><p>Hyperinflation in chronic obstructive pulmonary disease (COPD) patients worsens on exertion/exercise when breathing frequency increases. Fast breathing, paced at 40 breaths per minute using a metronome (metronome-paced tachypnea, MPT), induces dynamic hyperinflation (DH) and can be performed during MRI. MPT in combination with phase-resolved functional lung (PREFUL) MRI can be used to assess stress-driven ventilation dynamics globally and regionally. A 90 s time series of one coronal slice centered to the trachea was acquired for PREFUL MRI during 60 s of resting tidal breathing (RTB) and 30 s of MPT at 40 breaths per minute in COPD patients and healthy volunteers. MPT detected DH in 12 out of 15 COPD patients and in 1 out of 15 healthy controls. During MPT, the global fractional ventilation decreased by 20% in healthy subjects (<i>p</i> = 0.01) and by 48% in COPD patients (<i>p</i> < 0.001). The end-expiratory lung area remained stable in healthy subjects and increased significantly by 7% in COPD patients over the course of MPT (<i>p</i> = 0.004). Younger, healthy volunteers adapted to increase breathing frequency by reducing tidal volume (global fractional ventilation), while older healthy volunteers showed less tidal volume reduction (<i>p</i> = 0.036). The MPT-induced change of regional ventilation homogeneity (flow volume loop cross-correlation, FVL-CC_MPT/RTB) increased with age in healthy volunteers (<i>p</i> = 0.039) likely due to the development of compensatory dystelectasis in younger volunteers leading to reduced homogeneity during MPT. In the future, the MPT test during MR imaging may be used for COPD treatment analysis and disease monitoring.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"22 1","pages":"2502671"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282751","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}