European Respiratory Journal最新文献

{"title":"GOLD Science Committee recommendations for the use of pre- and post-bronchodilator spirometry for the diagnosis of COPD.","authors":"Dave Singh, Robert Stockley, Antonio Anzueto, Alvar Agusti, Jean Bourbeau, Bartolome R Celli, Gerard J Criner, MeiLan K Han, Fernando J Martinez, Maria Montes de Oca, Obianuju B Ozoh, Alberto Papi, Ian Pavord, Nicolas Roche, Sandeep Salvi, Don D Sin, Thierry Troosters, Jadwiga Wedzicha, Jinping Zheng, Claus Volgelmeier, David Halpin","doi":"10.1183/13993003.01603-2024","DOIUrl":"10.1183/13993003.01603-2024","url":null,"abstract":"<p><p>The Global Initiative for Chronic Obstructive Lung Disease (GOLD) report states that the diagnosis of COPD should be considered in individuals with chronic respiratory symptoms and/or exposure to risk factors. Forced spirometry demonstrating airflow obstruction after bronchodilation is required to confirm the diagnosis using a threshold of forced expiratory volume in 1 s (FEV₁)/forced vital capacity (FVC) ratio <0.7. This GOLD Science Committee review weighs the evidence for using pre- or post-bronchodilator (BD) spirometry to diagnose COPD. Cohort studies have shown that pre- and post-BD spirometry give concordant diagnostic results in most cases, although the prevalence of COPD is up to 36% lower with post-BD values. Discordant results may occur in \"volume\" or \"flow\" responders. Volume responders have reduced FVC due to gas trapping causing FEV₁/FVC ≥0.7 pre-BD, but a volume response occurs post-BD with a greater improvement in FVC relative to FEV₁ decreasing the ratio to <0.7. Flow responders show a greater FEV₁ improvement relative to FVC which may increase FEV₁/FVC from <0.7 pre-BD to ≥0.7 post-BD; these individuals have an increased likelihood of developing post-BD obstruction during follow-up and require monitoring longitudinally. GOLD 2025 recommends using pre-BD spirometry to rule out COPD and post-BD measurements to confirm the diagnosis. This will reduce clinical workload. Post-BD results close to the threshold should be repeated to ensure a correct diagnosis is made. Post-BD measurements ensure that volume responders are not overlooked and limit COPD overdiagnosis.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":16.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of respiratory event-related electroencephalographic activity in obstructive sleep apnoea alone <i>versus</i> co-morbid insomnia and sleep apnoea.","authors":"Ali Abdul Ghafoor, Joshua B Hicks, A J Hirsch Allen, Andrew E Beaudin, Fredric Series, Amrit Singh, Patrick J Hanly, Ali Azarbarzin, Najib T Ayas, Mohammadreza Hajipour","doi":"10.1183/13993003.02087-2024","DOIUrl":"10.1183/13993003.02087-2024","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":16.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracing the origins of fibrotic fibroblasts: does the name matter? Look at the genes!","authors":"Arnaud A Mailleux, Aurélien Justet","doi":"10.1183/13993003.02170-2024","DOIUrl":"https://doi.org/10.1183/13993003.02170-2024","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":"65 2","pages":""},"PeriodicalIF":16.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular risk assessment in patients with COPD: reduce, reuse and recycle.","authors":"Miguel Divo, Ciro Casanova, Victor Pinto-Plata","doi":"10.1183/13993003.02103-2024","DOIUrl":"https://doi.org/10.1183/13993003.02103-2024","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":"65 2","pages":""},"PeriodicalIF":16.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply: A recommendation for increased airflow to relieve breathlessness: evidence in context is a strength of the GRADE approach.","authors":"Anne E Holland, Claudia Bausewein, Natasha Smallwood, Magnus Ekström","doi":"10.1183/13993003.02463-2024","DOIUrl":"https://doi.org/10.1183/13993003.02463-2024","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":"65 2","pages":""},"PeriodicalIF":16.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-induced lung disease: unwanted collateral damage.","authors":"Yet H Khor, Martin Kolb","doi":"10.1183/13993003.02260-2024","DOIUrl":"https://doi.org/10.1183/13993003.02260-2024","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":"65 2","pages":""},"PeriodicalIF":16.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal photopheresis for the prevention of rejection after lung transplantation: a prospective randomised controlled trial.","authors":"Alberto Benazzo, Ara Cho, Sophia Auner, Stefan Schwarz, Zsofia Kovacs, Dariga Ramazanova, Vera Kolovratova, Manuela Branka, Gabriela Muraközy, Elisabeth Hielle-Wittmann, Clemens Aigner, Konrad Hoetzenecker, Thomas Wekerle, Nina Worel, Robert Knobler, Peter Jaksch","doi":"10.1183/13993003.00733-2024","DOIUrl":"10.1183/13993003.00733-2024","url":null,"abstract":"<p><strong>Background: </strong>Lung transplant recipients have the worst long-term outcomes of all solid organs due to acute rejection and chronic lung allograft dysfunction (CLAD). Our objective was to investigate the efficacy of extracorporeal photopheresis (ECP) as a prophylactic treatment to prevent acute cellular rejection (ACR), cytomegalovirus (CMV) infections and reduce the risk of CLAD.</p><p><strong>Methods: </strong>This was a single-centre prospective randomised controlled trial conducted at the Medical University of Vienna (Vienna, Austria) between 2018 and 2020. It included 31 COPD recipients per group. The treatment group underwent ECP in addition to a standard triple-drug immunosuppression protocol after lung transplantation. The control group received standard triple-drug immunosuppressive therapy. The primary outcome was a composite outcome defined as incidence of high-grade ACR, CMV infection or CLAD within 24 months after lung transplantation.</p><p><strong>Results: </strong>In the control group, 19 patients (61.3%) achieved the primary combined end-point compared with only six patients (19.4%) in the treatment group (p<0.001). Freedom from high-grade ACR was significantly greater in the ECP group (p=0.045). Cumulative A scores were significantly lower in the ECP group than in the control group at 3 months (0.18±0.44 <i>versus</i> 0.56±0.94; p<0.05) and at 12 months (0.25±0.48 <i>versus</i> 1.0±1.45; p=0.002). The rate of infections was lower in the ECP group with five cases and 67 cumulative hospital days compared with 22 cases and 309 days in the control group (p=0.002). Freedom from CLAD at 3 years was significantly greater in the ECP group (p=0.015).</p><p><strong>Conclusion: </strong>Adding ECP to standard triple immunosuppression resulted in a significant reduction of the number of ACR episodes and significantly lower incidence of CLAD.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":16.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First Assessment of Photon-Counting CT for Virtual Bronchoscopic Navigation.","authors":"Marcel Opitz, Faustina Funke, Kaid Darwiche, Sebastian Zensen, Marko Frings, Luca Salhöfer, Johannes Haubold, Michael Forsting, Fabian Doerr, Servet Bölükbas, Filiz Oezkan, Jane Winantea, Hanna Zellerhoff, Rüdiger Karpf-Wissel, Johannes Wienker, Dirk Westhölter, Matthias Welsner, Christian Taube, Erik Büscher","doi":"10.1183/13993003.02476-2024","DOIUrl":"https://doi.org/10.1183/13993003.02476-2024","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":16.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ECG-based risk factors for adverse cardiopulmonary events and treatment outcomes in COPD.","authors":"R Chad Wade, Fernando J Martinez, Gerard J Criner, Lee Tombs, David A Lipson, David M G Halpin, MeiLan K Han, Dave Singh, Robert A Wise, Ravi Kalhan, Mark T Dransfield","doi":"10.1183/13993003.00171-2024","DOIUrl":"10.1183/13993003.00171-2024","url":null,"abstract":"<p><strong>Background: </strong>COPD has high mortality, compounded by comorbid cardiovascular disease. We investigated two ECG markers, Cardiac Infarction Injury Score (CIIS) and P pulmonale, as prognostic tools for adverse cardiopulmonary events in COPD.</p><p><strong>Methods: </strong>This was a <i>p</i> <i>ost hoc</i> analysis of the IMPACT trial. Outcomes included odds (odds ratio, 95% confidence intervals) of adverse cardiopulmonary events stratified by CIIS threshold (<20 <i>versus</i> ≥20) and P pulmonale (baseline). Events included all-cause death, hospitalisation or death, cardiovascular adverse event of special interest, severe COPD exacerbations, and moderate/severe COPD exacerbations. We also assessed the effects of fluticasone furoate/umeclidinium/vilanterol <i>versus</i> fluticasone furoate/vilanterol or umeclidinium/vilanterol based on CIIS and P pulmonale.</p><p><strong>Results: </strong>We included 9448 patients. Patients with CIIS ≥20 (<i>versus</i> CIIS <20) had greater odds of all-cause death (OR 1.73, 95% CI 1.27-2.37, p<0.001), hospitalisation or death (OR 1.33, 95% CI 1.17-1.50, p<0.001), cardiovascular adverse event of special interest (OR 1.27, 95% CI 1.08-1.48, p<0.005), severe COPD exacerbations (OR 1.41, 95% CI 1.21-1.64, p<0.001) and moderate/severe COPD exacerbations (OR 1.25, 95% CI 1.13-1.40, p<0.001). Patients with P pulmonale (<i>versus</i> without) had greater odds of all-cause death (OR 2.25, 95% CI 1.54-3.29, p<0.001), hospitalisation or death (OR 1.51, 95% CI 1.28-1.79, p<0.001), severe COPD exacerbations (OR 2.00, 95% CI 1.65-2.41, p<0.001) and moderate/severe COPD exacerbations (OR 1.25, 95% CI 1.08-1.46, p<0.001). A combined model demonstrated that patients with CIIS ≥20 and P pulmonale had increased risk of all-cause death (OR 3.38, 95% CI 1.23-9.30, p=0.019), hospitalisation or death (OR 1.61, 95% CI 1.14-2.22, p=0.004) and rate of severe COPD exacerbations (OR 1.89, 95% CI 1.22-2.91, p=0.004) and moderate/severe COPD exacerbations (OR 1.25, 95% CI 1.00-1.56, p=0.046). The risk of all-cause death and cardiovascular adverse events of special interest was reduced with fluticasone furoate/umeclidinium/vilanterol <i>versus</i> umeclidinium/vilanterol in patients with CIIS ≥20, but not CIIS <20.</p><p><strong>Conclusions: </strong>These findings suggest the potential clinical relevance of CIIS and P pulmonale as risk indicators for adverse cardiopulmonary events in COPD.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":16.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The McMaster Cough Severity Questionnaire (MCSQ): a cough severity instrument for patients with refractory chronic cough.","authors":"Elena Kum, Gordon H Guyatt, Rayid Abdulqawi, Peter Dicpinigaitis, Lieven Dupont, Stephen K Field, Cynthia L French, Peter G Gibson, Richard S Irwin, Faye Johnston, Lorcan McGarvey, Robert Newman, Nada Popovic, Jaclyn A Smith, Woo-Jung Song, Paul M O'Byrne, Imran Satia","doi":"10.1183/13993003.01565-2024","DOIUrl":"10.1183/13993003.01565-2024","url":null,"abstract":"<p><strong>Background: </strong>Cough severity represents an important end-point to assess the impact of therapies for patients with refractory chronic cough (RCC). Our objective was to develop a new patient-reported outcome measure addressing cough severity in patients with RCC.</p><p><strong>Methods: </strong>Phase 1 (item generation): a systematic survey, focus groups and expert consultation generated 51 items. Phase 2 (item reduction): from a list of 51 items, 100 patients identified those they had experienced in the previous year and rated their importance on a 5-point scale. The McMaster Cough Severity Questionnaire (MCSQ) included items reported to occur most frequently and that had the highest importance scores. Patient feedback on the MCSQ led to elimination of redundant items. Another 100 patients completed the MCSQ, from which we performed an exploratory factor analysis and a Rasch analysis to further refine items on the MCSQ.</p><p><strong>Results: </strong>Previous publications report on the details of Phase 1. Phase 2 led to selection of 15 items from the initial 51. Patient feedback on the 15 items led to elimination of five redundant items. An exploratory factor analysis of the 10-item MCSQ led to the selection of two domains, and the elimination of one item that demonstrated cross-loading and another that had high inter-item correlations. A Rasch analysis of the 8-item MCSQ confirmed that the response options functioned in a logically progressive manner and that no items exhibited differential item functioning. The final 8-item MCSQ has a 1-week recall period and includes two domains (intensity and frequency). The 8-item MCSQ had high internal consistency (Cronbach's α=0.89), proved able to distinguish different levels of cough severity (person separation index 0.89) and demonstrated high cross-sectional convergent validity (Pearson's correlation 0.76, 95% CI 0.66-0.83) with the 100-mm cough severity visual analogue scale.</p><p><strong>Conclusions: </strong>Initial evidence supports the validity of the MCSQ, an 8-item instrument measuring cough severity in patients with RCC. Future studies should evaluate its properties in measuring change over time.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":16.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}