ERJ Open Research最新文献

{"title":"Acute effects of 50 mg additive oral sildenafil on invasive exercise haemodynamics in pulmonary vascular disease.","authors":"Simon R Schneider, Mona Lichtblau, Julian Müller, Meret Bauer, Laura Mayer, Esther I Schwarz, Michael Furian, Stéphanie Saxer, Silvia Ulrich","doi":"10.1183/23120541.01392-2024","DOIUrl":"10.1183/23120541.01392-2024","url":null,"abstract":"<p><strong>Background and aims: </strong>Patients with precapillary pulmonary hypertension (PH) due to pulmonary vascular disease (PVD) have reduced exercise capacity, limiting daily activity and quality of life. Phospodiesterase-5 inhibitors, including sildenafil, are used to treat PVD. This study examined effects of sildenafil on pulmonary haemodynamics during exercise in PVD.</p><p><strong>Method: </strong>PVD patients diagnosed with pulmonary arterial hypertension (PAH) or chronic thromboembolic PH (CTEPH) underwent right heart catheterisation assessed at rest and during mild exercise. Main outcomes were mean pulmonary artery pressure (mPAP), cardiac output (CO) and the mPAP/CO slope before and ∼60 min after additive sildenafil (50 mg oral).</p><p><strong>Results: </strong>22 PVD patients (14 PAH, 8 CTEPH, 9 women and 15 pretreated (9 combination therapy)) with a mean±sd age of 54±14 years, mPAP 39±10 mmHg, CO 4.7±1.5 L·min^-1 and pulmonary vascular resistance 6.9±3.8 WU were included. After sildenafil, mPAP and CO at rest were unchanged, but at end-exercise, mPAP and the mPAP/CO slope significantly decreased (mPAP 61±16 <i>versus</i> 54±16 mmHg; mean difference -7, 95% confidence interval (CI) -11 to -4; p<0.001 and mPAP/CO slope 9.8±4.9 <i>versus</i> 6.6±3.3; -3, 95% CI -4.9 to -1.2; p=0.002). The mean systemic arterial pressure was significantly lower after additive sildenafil at rest (-9 mmHg, -13 to -5; p<0.001) and at end-exercise (-9 mmHg, -13 to -5; p<0.001). One patient experienced dizziness.</p><p><strong>Conclusions: </strong>Patients with PVD, showed favourable acute pulmonary haemodynamic changes during exercise after additive sildenafil, indicated by a reduced mPAP and mPAP/CO slope. Sildenafil was generally well tolerated despite lower blood pressure. Further investigation is needed to determine if sildenafil as a \"pill-in-the-pocket\" strategy improves exercise capacity in PVD patients.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-zero risk of adverse psychological reactions induced by experimental dyspnoea studies in healthy volunteers: possible ethical implications.","authors":"Sophie Lavault, Marie-Cécile Niérat, Nathalie Nion, Caroline Didier, Laure Serresse, Capucine Morélot-Panzini, Thomas Similowski","doi":"10.1183/23120541.01342-2024","DOIUrl":"10.1183/23120541.01342-2024","url":null,"abstract":"<p><strong>Background: </strong>Experimentally inducing dyspnoea in healthy volunteers is a powerful research tool. Even though this approach is not considered to carry particular risks, dyspnoea occurs in a general context of stress. We hypothesised that experimental dyspnoea could be traumatic in some individuals, with immediate or delayed adverse psychological reactions.</p><p><strong>Methods: </strong>40 participants (median (interquartile range) age 38.7 (29.7-49.1) years; 20 women) were exposed, in random order, to inspiratory threshold loading (ITL; \"excessive breathing effort\"; unpleasantness rating 6 (4-7) on a 0-10 scale) and carbon dioxide stimulation with restricted ventilatory response (CO₂-rv; \"air hunger\"; unpleasantness rating 7 (7-8)). Participants were evaluated immediately after induced dyspnoea, at 7 days and after a further 3 months.</p><p><strong>Results: </strong>Peritraumatic Distress Inventory (PDI) scores were higher immediately after CO₂-rv than after ITL (3 (1-6.5) <i>versus</i> 2 (0-3); p<0.0001). After 7 days, six participants (15%) had an Impact of Event Scale-Revised (IES-R) score ≥12 (high risk of post-traumatic stress disorder (PTSD)). They had significantly higher baseline anxiety trait indicators than the participants with an IES-R score <12 (baseline Anxiety Sensitivity Index 27.5 (14.75-61.25) <i>versus</i> 10 (3-19); p=0.0087). At 3 months, no participant had a PTSD Checklist for DSM-5 (PCL-5) score suggestive of PTSD (1 (0-4), range 0-23, threshold 33) but the six participants with IES-R ≥12 on day 7 had significantly higher PCL-5 scores (13.5 (1-21.5) <i>versus</i> 0 (0-4); p=0.0014).</p><p><strong>Conclusions: </strong>Although no severe situations were encountered, this study highlights the need for caution when designing experimental dyspnoea studies, particularly when involving individuals with high trait anxiety.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical validation of a machine-learned, point-of-care system to IDENTIFY pulmonary hypertension.","authors":"Dalton McLean, John Rommel, John A Steuter, William S Carroll, Mark Rabbat, Sudarshan Rajagopal, Venkatraman Srinivasan, Dean J Kereiakes, Michael C Roberts, Abhijit Raval, Navid Nemati, Farhad Fathieh, Timothy Burton, Horace R Gillins, Ian Shadforth, Shyam Ramchandani, Charles R Bridges, Vallerie V McLaughlin","doi":"10.1183/23120541.01287-2024","DOIUrl":"10.1183/23120541.01287-2024","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary hypertension (PH) is a collection of diverse disorders, defined by mean pulmonary artery pressure (mPAP) ≥21 mmHg (most recent guidelines) or ≥25 mmHg (previous guidelines, that underpins the field's past work) measured by right heart catheterisation (RHC). Considering the difficulties in diagnosing PH and the subsequent treatment delays, there is a need for novel diagnostics to enable prompt detection.</p><p><strong>Methods: </strong>An algorithm to assess mPAP elevation was validated using subjects with elevated mPAP from RHC (positive cohort) and subjects with low probability of PH by stringent screening of transthoracic echocardiography (TTE) PH indicators (negative cohort). 25 mmHg and 21 mmHg were pre-specified as the co-primary and secondary sensitivity end-points, respectively, at 0.70. Specificity was the co-primary end-point at 0.60. The algorithm cut-point was pre-defined. The area under the receiver operator characteristic curve (ROC-AUC) was assessed at both mPAP thresholds.</p><p><strong>Findings: </strong>462 subjects were consecutively enrolled across 18 US clinical sites between August 2019 and September 2022. Sensitivity at 25 mmHg and 21 mmHg was 0.82 (95% CI 0.78-0.87) and 0.78 (95% CI 0.73-0.82), respectively, with specificity of 0.92 (95% CI 0.87-0.96), passing the study end-points. The ROC-AUC values at 25 mmHg and 21 mmHg were 0.95 (95% CI 0.93-0.96) and 0.93 (95% CI 0.91-0.95), respectively. Further, performance was similar across PH subgroups (pre-capillary, combined pre- and post-capillary, and isolated post-capillary), as well as between men and women.</p><p><strong>Interpretation: </strong>The algorithm's performance is comparable, or possibly superior to, TTE, given that the tricuspid regurgitant velocity is not measurable in up to 41% of TTE cases. The test is a stress-free, noninvasive front-line test, presenting advantages to patients, physicians and healthcare systems.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Online home spirometry in national pulmonary fibrosis care: insights from daily practice.","authors":"Gizal Nakshbandi, Catharina C Moor, Tonia Magrì, Marcel Veltkamp, Suzan F M Nijman, Marieke J Overbeek, Paul Bresser, J J M Geelhoed, Renee E Jonkers, Adriane D M Vorselaars, Lian Trapman, Luca Richeldi, Sara Baart, Remy L M Mostard, Marlies S Wijsenbeek","doi":"10.1183/23120541.01234-2024","DOIUrl":"10.1183/23120541.01234-2024","url":null,"abstract":"<p><strong>Background: </strong>Monitoring lung function course in patients with pulmonary fibrosis is crucial to guide treatment decisions. Online home spirometry holds great potential for close monitoring and improving care access in times of pressured healthcare systems. However, little data is available on its large-scale use in daily practice. We evaluated the clinical applicability of online home spirometry in pulmonary fibrosis care.</p><p><strong>Methods: </strong>We analysed data of a nationwide Dutch cohort of patients with idiopathic pulmonary fibrosis (IPF) and other forms of pulmonary fibrosis (PF) that used a home monitoring programme with home spirometry (forced vital capacity (FVC)) as part of daily practice. Changes in FVC were evaluated with a joint model. Within-patient variability was measured using coefficient of variation. Home spirometry use over time and patient experiences were assessed.</p><p><strong>Results: </strong>Online home spirometry data of 334 patients (IPF 73.1%) were analysed. Patients with IPF had a mean baseline FVC of 3.02 L (95% CI: 2.27-3.79), with a mean annualised decline of 170 mL (4.0%). Patients with PF had a mean baseline FVC of 2.81 L (95% CI: 2.07-3.55) with a mean annualised decline of 88 mL (1.2%). Mean±sd within-patient variability was 5.6±4.6%. Overall patient satisfaction was high, and after 1 year 63.4% still performed online home spirometry.</p><p><strong>Conclusion: </strong>Online home spirometry is feasible on a large scale in daily clinical practice to monitor disease trajectories in patients with IPF and PF. Online home spirometry could guide management decisions and improve care access for a majority of patients with pulmonary fibrosis.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum immunoglobulin A as a biomarker for respiratory syncytial virus infection in children aged <2 years.","authors":"Annick Moureau, Rafael Mikolajczyk, Cornelia Gottschick, Bianca Klee, Rob van Binnendijk, Rutger Schepp, Ryan S Thwaites, Donghui Zhang, Yichen Jia, Charlotte Vernhes","doi":"10.1183/23120541.01288-2024","DOIUrl":"10.1183/23120541.01288-2024","url":null,"abstract":"<p><strong>Aims: </strong>Past research suggested respiratory syncytial virus (RSV) specific serum immunoglobulin A (IgA) antibodies as a biomarker of previous RSV infections in young infants accounting for maternal immunity. This study aimed to confirm this association and to establish a serological threshold for discriminating RSV-naïve infants from those who have experienced RSV.</p><p><strong>Material and methods: </strong>This study involves 135 infants from the LoewenKIDS study with nasal swabs collected at each acute respiratory infection, and serum samples collected at ages 1 and 2 years. RSV presence in swabs was ascertained by reverse transcriptase PCR; RSV-specific IgG and IgA antibody levels against five different structural proteins and RSV neutralising antibodies were measured in sera. Robust Mixture Discriminant Analysis was used to determine the cut-off values and account for false negatives.</p><p><strong>Results: </strong>Of 135 included infants, 131 had available data at year 1 (Y1) and 95 at year 2 (Y2). Pre-F IgA concentrations were higher in infants with PCR-confirmed RSV infections. There was a further increase in IgA, IgG and neutralising antibody titre concentrations from Y1 to Y2 consistent with re-infections. Based on robust mixture discriminant analysis, the cut-off values of pre-F IgA level indicative of past RSV infection were 0.23 AU·mL^-1 at Y1 and 0.22 AU·mL^-1 at Y2.</p><p><strong>Conclusion: </strong>This study shows that in children aged <2 years, a previous RSV infection is accompanied by serum pre-F IgA antibody levels above 0.22 AU·mL^-1, a value close to a previously proposed cut-off (0.19 AU·mL^-1) based on seroresponse data only. The confirmed threshold can be of use in studies assessing vaccination strategies.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ramadan fasting in chronic respiratory diseases: do we have evidence-based recommendations?","authors":"Ahmed Fahim","doi":"10.1183/23120541.00248-2025","DOIUrl":"10.1183/23120541.00248-2025","url":null,"abstract":"<p><p><b>Ramadan fasting is important for Muslim adults across the globe and has implications for patients with chronic respiratory disorders. There is a lack of evidence-based recommendations to guide decision to fast or adjust therapy during Ramadan.</b> https://bit.ly/41PYoOi.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of pulmonary hypertension in idiopathic pulmonary fibrosis using random forest models and automated measures of central computed tomography structures.","authors":"Toru Shirahata, Pietro Nardelli, Sirus Jesudasen, Ruben San José Estépar, Ariel H Curiale, Badar Patel, Eileen Harder, Rajan Saggar, Aaron B Waxman, Rebecca R Vanderpool, George R Washko, Sydney B Montesi, Raúl San José Estépar, Farbod N Rahaghi","doi":"10.1183/23120541.01057-2024","DOIUrl":"10.1183/23120541.01057-2024","url":null,"abstract":"<p><strong>Objectives: </strong>Since pulmonary hypertension (PH) worsens the prognosis of idiopathic pulmonary fibrosis (IPF), early prediction of PH is crucial for timely intervention. This study aims to develop and validate a machine learning model to predict PH using automated computed tomography (CT)-based 3D measurements, particularly central cardiovascular structures, segmented by a publicly available tool.</p><p><strong>Methods: </strong>We retrospectively studied 163 IPF patients who underwent both thin-section chest CT (contrast-enhanced and non-contrast) and right heart catheterisation within 2 years (78.5% within 6 months). Central CT structures were segmented using the TotalSegmentator Neural Network Version 1. We also manually measured pulmonary artery (PA) and ascending aorta (A) diameters. Random forest (RF) and logistic regression (LR) models were created and the model's reliability was assessed with 10-fold cross-validation. Shapley additive explanation (SHAP) analysis was performed to understand the contribution of each variable to the RF model.</p><p><strong>Results: </strong>Of the 163 patients, 75 had PH (46.0%). Significant differences were found in race, body mass index, right atrial (RA) volume, and PA volume between PH and non-PH patients. The RF model outperformed the LR model, showing higher area under the curve (AUC) (0.87 <i>versus</i> 0.82). Replacing PA volume with the PA/A ratio in the RF model decreased performance (AUC: 0.87 <i>versus</i> 0.79). SHAP identified PA and RA volumes as key features. No significant differences were observed between mean pulmonary arterial pressure and RA or PA volume in non-contrast CT compared to contrast-enhanced CT.</p><p><strong>Conclusion: </strong>The RF model with volumetric measures showed superior predictive performance for PH. Notably, both the RF model and segmentations of central CT structures are automated, facilitating seamless integration into clinical practice.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home is where spirometry should be: enhancing care for individuals with pulmonary fibrosis.","authors":"Toby M Maher","doi":"10.1183/23120541.00468-2025","DOIUrl":"10.1183/23120541.00468-2025","url":null,"abstract":"<p><p><b>Home spirometry is an important tool for monitoring patients with pulmonary fibrosis. Modern handheld spirometers combined with web-based platforms permit minimally intrusive, patient-centric measurement of FVC, providing clinically important data.</b> https://bit.ly/4jSh4Er.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ramadan fasting for patients with chronic respiratory diseases: a systematic review and consensus recommendations for healthcare professionals.","authors":"Fasihul Khan, Sameen Toor, Rayid Abdulqawi, Huzaifa Adamali, James D Chalmers, Nazia Chaudhuri, Nazim Ghouri, R Gisli Jenkins, Anna Murphy, Najib Rahman, Rafaqat Rashid, Imran Satia, Salman Siddiqui, Salman Waqar","doi":"10.1183/23120541.01102-2024","DOIUrl":"10.1183/23120541.01102-2024","url":null,"abstract":"<p><strong>Background: </strong>Ramadan, observed by nearly 2 billion Muslims worldwide, involves fasting from dawn to sunset, which can present challenges for individuals with chronic respiratory diseases due to altered medication regimens and oral intake restrictions. This study aimed to synthesise current evidence and develop consensus recommendations for managing asthma, COPD, interstitial lung disease (ILD) and bronchiectasis during Ramadan.</p><p><strong>Methods: </strong>A comprehensive search of electronic databases including MEDLINE, Embase and Google Scholar was conducted following a pre-specified protocol (PROSPERO identifier number CRD42024532759) to identify studies on Ramadan fasting outcomes in individuals with chronic respiratory diseases. The findings informed consensus recommendations stratified by the risk of adverse outcomes using International Diabetes Federation and the Diabetes and Ramadan risk assessment criteria. An international expert group of medical and religious experts refined these guidelines, achieving consensus approval.</p><p><strong>Results: </strong>11 studies met the inclusion criteria, primarily addressing asthma and COPD, with no relevant studies on ILD or bronchiectasis. The studies indicated that fasting did not significantly impact hospitalisation rates or lung function tests in individuals with stable asthma and COPD. However, small sample sizes and methodological limitations restricted generalisability. 19 recommendations were developed to support patients considering fasting, emphasising pre-Ramadan consultations, individualised risk assessments, and adjustments to medication regimens.</p><p><strong>Conclusion: </strong>This systematic review highlights the need for larger, well-designed studies to understand Ramadan fasting implications across chronic respiratory diseases. The developed recommendations provide a structured approach to assess fasting risks, ensuring informed and safe guidance during Ramadan. Future research should address identified gaps, supporting evidence-based guidelines that reconcile medical and religious considerations.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and acute physiological responses to supramaximal high-intensity interval training in COPD: a randomised crossover trial.","authors":"Johan Jakobsson, Jana De Brandt, Mattias Hedlund, Anna-Clara Rullander, Thomas Sandström, André Nyberg","doi":"10.1183/23120541.01321-2024","DOIUrl":"10.1183/23120541.01321-2024","url":null,"abstract":"<p><strong>Background: </strong>Extrapulmonary manifestations, including cognitive impairment and reduced muscle and cardiovascular function is common in COPD. While high-intensity exercise offers extrapulmonary benefits, its implementation in COPD is challenging. This randomised crossover trial examined the feasibility and physiological responses of a novel supramaximal high-intensity interval-training (SupraHIIT) protocol compared with moderate-intensity continuous training (MICT) in people with COPD and matched healthy controls (HCs).</p><p><strong>Methods: </strong>16 people with COPD and 16 HCs performed SupraHIIT and MICT. SupraHIIT consisted of ten 6-s intervals at ≈150% and ≈200% of maximum aerobic power (MAP), while MICT was performed for 20 min at 60% of MAP. Outcomes were exercise intensity, change in exerkines, feasibility and cardiorespiratory demand of the modalities.</p><p><strong>Results: </strong>SupraHIIT was feasible and enabled up to a 3.5-fold increase in external exercise intensity compared with MICT (184±66 and 245±88 <i>versus</i> 71±22 W in COPD; p<0.001). All participants could complete SupraHIIT, which was the preferred modality in both groups (p<0.01), whereas 5 of 16 participants with COPD interrupted MICT due to intolerable dyspnoea or exhaustion (p=0.005). Both modalities increased plasma brain-derived neurotrophic factor (pBDNF) by an average of 59% (range 30-87%; p<0.05). When normalised for duration at target power, SupraHIIT produced a 5-10-fold greater increase than MICT. Both modalities lead to a variable response in other exerkines including clusterin, lactate, hepatocyte growth factor and interleukin-6.</p><p><strong>Conclusion: </strong>In COPD, short-duration SupraHIIT is more feasible and enables markedly higher external exercise intensities than MICT. By elevating pBDNF and other potentially beneficial exerkines, it shows potential for extrapulmonary benefits.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}