Respiratory medicine最新文献

{"title":"Associations of small airway dysfunction assessed by impulse oscillometry with lung function decline and exacerbations in participants with chronic obstructive pulmonary disease: A prospective cohort study in China","authors":"Lifei Lu ,&nbsp;Fan Wu ,&nbsp;Gaoying Tang ,&nbsp;Qi Wan ,&nbsp;Zhishan Deng ,&nbsp;Jieqi Peng ,&nbsp;Cuiqiong Dai ,&nbsp;Kunning Zhou ,&nbsp;Xiaohui Wu ,&nbsp;Shuqing Yu ,&nbsp;Yongqing Huang ,&nbsp;Changli Yang ,&nbsp;Shengtang Chen ,&nbsp;Pixin Ran ,&nbsp;Yumin Zhou","doi":"10.1016/j.rmed.2025.108075","DOIUrl":"10.1016/j.rmed.2025.108075","url":null,"abstract":"<div><h3>Introduction</h3><div>Small airway dysfunction (SAD) assessed by impulse oscillometry (IOS) was common in patients with chronic obstructive pulmonary disease (COPD). However, little is known about the associations between IOS-defined small airway dysfunction (SAD) and the long-term prognosis of COPD. This study aimed to explore the associations between IOS-defined SAD, lung function decline and exacerbations in patients with COPD.</div></div><div><h3>Methods</h3><div>We analyzed baseline and 2-year follow-up data from the prospective cohort study in China. We defined SAD using IOS parameters Z-score greater than the 1.645 or less than −1.645. Subsequently, these patients were divided into three groups based on the different criteria defined SAD using IOS (normal group [none IOS parameters abnormalities], inconsistent SAD [any IOS parameters abnormalities, but not all], consistent SAD [all of IOS parameters abnormalities]). Negative binomial regression was conducted to analyze the associations between SAD and exacerbations, while a multivariable linear regression model was utilized to identify associations between SAD and lung function decline.</div></div><div><h3>Results</h3><div>833 patients with COPD were enrolled in our study. SAD (defined by X5, AX, and Fres z-score) was associated with a faster decline in lung function and higher risk of exacerbation. Meanwhile, for inconsistent diagnosis of SAD, we observed that patients with consistent SAD and inconsistent SAD experienced a faster decline in FEV₁ and higher risk of exacerbations than those with normal group.</div></div><div><h3>Conclusions</h3><div>IOS-defined SAD was associated with worse outcomes in patients with COPD, and further clinical trials are needed to clarify whether early intervention to reduce the severity of small airway lesions can delay the progress of COPD.</div></div><div><h3>Trial registration</h3><div>Chinese Clinical Trial Registry, ChiCTR1900024643. Registered on 19 July 2019.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108075"},"PeriodicalIF":3.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Indacaterol vs Tiotropium in COPD patients due to biomass exposure in improving quality of life and reducing symptoms","authors":"Robinson E. Robles-Hernández ,&nbsp;Francisco Montiel-Lopez ,&nbsp;Mónica Velázquez-Uncal ,&nbsp;Raúl H. Sansores ,&nbsp;Rafael J. Hernández-Zenteno ,&nbsp;Rogelio Pérez-Padilla ,&nbsp;Alejandra Ramírez-Venegas","doi":"10.1016/j.rmed.2025.108074","DOIUrl":"10.1016/j.rmed.2025.108074","url":null,"abstract":"<div><h3>Background</h3><div>Few treatment trials have been tested on COPD patients associated with biomass smoke exposure (COPD-B). Patients with COPD-B improve hyperinflation 24 hours after inhaling long-acting beta-agonist (LABA) and long-acting muscarinic antagonist (LAMA), and after six months of treatment, improve symptoms, quality of life, and exacerbations. However, the usefulness of LAMA or LABA for an extended period for improving quality of life and symptoms has not yet been demonstrated in the COPD-B phenotype. The primary aim of this trial was to compare tiotropium (TIO) with indacaterol (IND) in improving the quality of life (QOL) measured by the Saint George's Respiratory Questionnaire (SGRQ) in COPD-B after six months of treatment.</div></div><div><h3>Methods</h3><div>A randomized, open-label, parallel-group clinical trial designed at a third-level health institute in Mexico City. Seventy-three COPD-B women were randomly assigned to either 150 mcg of indacaterol or 18 mcg of tiotropium once daily for 24 weeks.</div></div><div><h3>Results</h3><div>197 patients underwent the screening visit, of which 73 were randomized. There was no significant change in the three domains nor the total score of the SGRQ in either treatment group. For secondary outcomes, the TIO group showed a substantial change in the IC of 160 mL (p=0.016) after six month-treatment. For both treatment groups, a significant reduction in BDI/TDI score of 3 points was shown (p&lt;0.001).</div></div><div><h3>Conclusions</h3><div>Neither TIO nor IND improved quality of life, nor dyspnea evaluated by the mMRC scale, but TIO did improve inspiratory capacity, and TIO and IND improved dyspnea evaluated by BDI/TDI.</div></div><div><h3>Clinical Trial Registration</h3><div>NCT05506865</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108074"},"PeriodicalIF":3.5,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764735","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":"Effectiveness of a respiratory therapist-led, community-based asthma program in an under resourced rural border town In California","authors":"Torrie Staten ,&nbsp;Ping-Hui Liu ,&nbsp;Catalina Holt ,&nbsp;Abdullah Alismail","doi":"10.1016/j.rmed.2025.108071","DOIUrl":"10.1016/j.rmed.2025.108071","url":null,"abstract":"<div><h3>Introduction</h3><div>Asthma affects over 300 million people globally, with a higher prevalence in Imperial County, California, due to environmental and social factors. The Asthma Community Linkages Project (ACLP) seeks to reduce emergency visits and enhance asthma self-management through respiratory therapist-led(RT-Led) initiatives. The purpose of this study was to evaluate the effectiveness of using RT-led community-based program in Imperial Country, CA.</div></div><div><h3>Methods</h3><div>Conducted as a quality improvement study, the ACLP is a community-based initiative piloted in Imperial County's local hospitals and rural health clinics through the Asthma Management Program (AMP) and Asthma Wellness Program (AWP) from 2017 to 2020. Participants included 233 patients diagnosed with asthma, identified through ED visits. The program incorporated baseline clinical services, educational modules, and up to three home visits focused on asthma education and trigger mitigation. Data analysis employed paired t-tests and chi-squared tests to assess changes in Asthma Control Test (ACT) scores and ED visit frequency pre-and post-intervention.</div></div><div><h3>Results</h3><div>The study observed significant improvements in asthma control, with ACT scores rising significantly from 15.5 ± 3.03 to 21.33 ± 1.64 (p &lt; 0.001) within six months post-intervention. Notably, completing all three home visits was significantly associated with reduced ED visits at six and twelve months (p &lt; 0.01; p = 0.046). Among the participants, 58.4 % received at least one home visit, underscoring the intervention's reach and impact.</div></div><div><h3>Conclusion</h3><div>The ACLP, a respiratory therapist-led asthma program in Imperial County, California, improved asthma management and reduced emergency department visits. Using an evidence-based practice model and the Plan-Do-Check-Act framework, it addressed environmental and social health determinants through an interdisciplinary approach. The results demonstrated better asthma control in underserved areas, offering valuable insights for similar initiatives in resource-limited settings.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108071"},"PeriodicalIF":3.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754253","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":"Pulse corticosteroid therapy in interstitial lung disease-associated with anti-aminoacyl-tRNA synthetase antibodies: Comparable efficacy with potential for reduced adverse events","authors":"Shota Kaburaki,&nbsp;Toru Tanaka,&nbsp;Koichiro Kamio,&nbsp;Akihiko Miyanaga,&nbsp;Namiko Taniuchi,&nbsp;Yosuke Tanaka,&nbsp;Kazuo Kasahara,&nbsp;Masahiro Seike","doi":"10.1016/j.rmed.2025.108070","DOIUrl":"10.1016/j.rmed.2025.108070","url":null,"abstract":"<div><h3>Background and objective</h3><div>The optimal treatment modality for interstitial lung disease (ILD) associated with anti-aminoacyl-tRNA synthetase (ARS) antibodies remains controversial. This study aimed to compare the efficacy and safety of pulse corticosteroid therapy with that of conventional corticosteroid therapy in patients with anti-ARS ILD.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 62 patients with anti-ARS ILD. Patients were divided into two groups: Those who received pulse corticosteroid therapy (500–1000 mg of methylprednisolone intravenously for three days) and those who received conventional corticosteroid therapy. Primary outcomes included initial treatment response at one year and disease recurrence. Secondary outcomes were alterations in pulmonary function tests, KL-6 levels, prednisolone dose, and adverse events.</div></div><div><h3>Results</h3><div>Both the pulse corticosteroid therapy group and the conventional therapy group had similar rates of initial treatment improvement (90.3 % vs. 77.4 %, p = 0.301), with no significant differences in recurrence-free survival. Improvements in pulmonary function tests were comparable between the two groups. At 12 months, the mean daily prednisolone dose was 3.9 mg in the pulse therapy group compared with 6.0 mg in the conventional therapy group. The pulse corticosteroid therapy group also experienced fewer adverse events (25.8 % vs. 61.3 %, p = 0.010).</div></div><div><h3>Conclusion</h3><div>Pulse corticosteroid therapy provides similar treatment efficacy, earlier reduction in corticosteroid dosage, and a lower incidence of adverse events compared to conventional therapy in patients with anti-ARS ILD. These findings highlight the potential benefit of a steroid-sparing strategy, suggesting that pulse corticosteroid therapy may be considered an effective and safer option in managing this condition.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108070"},"PeriodicalIF":3.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oscillometry and spirometry derived ratios to assess small airways dysfunction in severe asthma patients taking tezepelumab","authors":"Robert Greig,&nbsp;Rory Chan,&nbsp;Brian Lipworth","doi":"10.1016/j.rmed.2025.108072","DOIUrl":"10.1016/j.rmed.2025.108072","url":null,"abstract":"","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108072"},"PeriodicalIF":3.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747193","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":"Alterations in gut microbial community structure in obstructive sleep apnea /hypopnea syndrome (OSAHS): A systematic review and meta-analysis","authors":"Ali Tahmasebi ,&nbsp;Rasa Beheshti ,&nbsp;Mohammadsina Mahmoudi ,&nbsp;Mahan Jalilzadeh ,&nbsp;Hanieh Salehi-Pourmehr","doi":"10.1016/j.rmed.2025.108077","DOIUrl":"10.1016/j.rmed.2025.108077","url":null,"abstract":"<div><h3>Objectives</h3><div>This systematic review investigates gut bacterial diversity and composition in patients with Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) and examines how these changes may contribute to cardiovascular complications.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted in PubMed, Web of Science, and Scopus up to March 2025. After removing duplicates, titles and abstracts were screened by two reviewers, and full texts were assessed for inclusion. Data extraction on study characteristics and outcomes was performed. Methodological quality was evaluated using the Joanna Briggs Institute checklist. α-diversity was assessed using richness and diversity indices, while β-diversity examined community structure differences. Meta-analysis was conducted using standardized mean differences (SMD) and confidence intervals (CIs), and heterogeneity was assessed with the Cochrane I² test.</div></div><div><h3>Results</h3><div>The review included 18 studies (16 adults, 2 pediatrics) examining the gut microbiome in OSAHS. Meta-analysis revealed significant reductions in α-diversity indices (Shannon, Chao1, observed species, ACE) in OSAHS patients, while Simpson's index showed no difference. β-diversity analyses showed distinct gut microbiome differences in OSA. Key differential bacteria included Bacteroides, Proteobacteria, Faecalibacterium, Ruminococcaceae, Megamonas, Oscillibacter, Dialister, Roseburia, and Lachnospira. Study quality was medium to high.</div></div><div><h3>Conclusion</h3><div>OSAHS is associated with significant gut microbiome alterations, including a reduction in beneficial bacteria and an increase in LPS-producing bacteria, leading to intestinal barrier dysfunction. These changes may contribute to systemic inflammation and elevate the risk of cardiovascular diseases.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108077"},"PeriodicalIF":3.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing methodological rigor in TCE for COPD rehabilitation","authors":"Jiahui Hong ,&nbsp;Shuding Yan ,&nbsp;Yue Lin","doi":"10.1016/j.rmed.2025.108073","DOIUrl":"10.1016/j.rmed.2025.108073","url":null,"abstract":"","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108073"},"PeriodicalIF":3.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the impact of electronic nicotine delivery systems on chronic obstructive pulmonary disease: A systematic review and meta-analysis","authors":"Ajay Malvi ,&nbsp;Mahalaqua Nazli Khatib ,&nbsp;Subbulakshmi Ganesan ,&nbsp;Mandeep Kaur ,&nbsp;Manish Srivastava ,&nbsp;Amit Barwal ,&nbsp;G.V. Siva Prasad ,&nbsp;Pranchal Rajput ,&nbsp;Rukshar Syed ,&nbsp;Ramesh Chander Hooda ,&nbsp;Brijendra Mohan ,&nbsp;Muhammed Shabil ,&nbsp;Diptismitha Jena ,&nbsp;Simranjeet Nanda ,&nbsp;Aseem Aneja ,&nbsp;Ganesh Bushi ,&nbsp;Rachana Mehta ,&nbsp;Renu Sah ,&nbsp;Prakasini Satapathy ,&nbsp;Shilpa Gaidhane","doi":"10.1016/j.rmed.2025.108059","DOIUrl":"10.1016/j.rmed.2025.108059","url":null,"abstract":"<div><h3>Background</h3><div>Electronic Nicotine Delivery Systems (ENDS), commonly known as e-cigarettes or vapes, have gained widespread popularity, particularly among young adults and former smokers. While marketed as a harm reduction tool, concerns have emerged regarding their long-term impact on respiratory health, particularly their association with chronic obstructive pulmonary disease (COPD). This systematic review and meta-analysis aimed to evaluate the relationship between ENDS use and COPD risk while considering tobacco smoking as a key confounder.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted across PubMed, Embase, and Web of Science for studies published up to September 20, 2024. Observational studies assessing the association between ENDS use and COPD risk were included. A random-effects meta-analysis was performed using R statistical software (version 4.4). Tobacco smoking, a key confounder in COPD research, was accounted for in many included studies, with adjustments varying across studies.</div></div><div><h3>Results</h3><div>Fifteen studies met the inclusion criteria. The pooled odds ratio (OR) for current ENDS use and COPD risk was 1.488 (95 % CI: 1.363–1.623). Former ENDS users had an OR of 1.839 (95 % CI: 1.513–2.234), and ever-users had an OR of 1.787 (95 % CI: 1.421–2.247). Sensitivity analyses confirmed the robustness of findings, and no publication bias was detected.</div></div><div><h3>Conclusion</h3><div>This meta-analysis provides evidence of a significant association between ENDS use and increased COPD risk, even after adjusting for tobacco smoking. Future research should standardize smoking adjustments and investigate the independent impact of ENDS use on COPD.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108059"},"PeriodicalIF":3.5,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the 1.1 mm cryoprobe versus flexible forceps for lung transplant acute allograft rejection diagnosis","authors":"Prasanth Balasubramanian ,&nbsp;Alanna Barrios-Ruiz ,&nbsp;Alejandra Yu Lee-Mateus ,&nbsp;Sofia Valdes-Camacho ,&nbsp;Bryan F. Vaca-Cartagena ,&nbsp;Rodrigo Funes-Ferrada ,&nbsp;Ana Garza-Salas ,&nbsp;Andras Khoor ,&nbsp;Francisco G. Alvarez ,&nbsp;Maher Baz ,&nbsp;Tathagat Narula ,&nbsp;Sadia Z. Shah ,&nbsp;Remzi Bag ,&nbsp;Sebastian Fernandez-Bussy ,&nbsp;David Abia-Trujillo","doi":"10.1016/j.rmed.2025.108061","DOIUrl":"10.1016/j.rmed.2025.108061","url":null,"abstract":"<div><h3>Background</h3><div>Transbronchial lung biopsy in lung transplant recipients has traditionally been performed via forceps (FBx) but is associated with poor-quality specimens and crush artifacts. The novel 1.1 mm cryoprobe (CBx) with oversheath could obtain a larger sample with better hemostatic control. We hence performed a study comparing FBx and CBx for surveillance biopsy in lung transplant recipients.</div></div><div><h3>Methods</h3><div>We conducted a prospective, observational single-center study of adult lung transplant recipients who underwent transbronchial biopsies during surveillance. The samples were obtained with standard transbronchial forceps and 1.1 mm cryoprobe through flexible bronchoscopy for each patient in the same procedure. Outcomes of FBx and CBx were compared and analyzed.</div></div><div><h3>Results</h3><div>We performed FBx and CBx in 49 patients with a mean age of 62 years, 51 % were male, and 82 % underwent bilateral lung transplant. The CBx yielded a significantly higher area of alveolated tissue compared to FBx (19.3 vs 5.4 mm², <em>p</em> &lt; 0.001). The diagnostic rate was higher with CBx compared to FBx with respect to acute rejection (100 % vs 96 %), airway inflammation (53 % vs 38 %) and chronic rejection (45 % vs 39 %) though none achieved statistical significance. No major bleeding or pneumothorax were noted in our study.</div></div><div><h3>Conclusion</h3><div>CBx with the 1.1 mm probe could provide a higher rate of detecting lung allograft dysfunction with an excellent safety profile. Similar studies with larger sample sizes are needed to prove statistical significance.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108061"},"PeriodicalIF":3.5,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of comorbid heart disease and depression/anxiety with multidimensional breathlessness in COPD – A cross-sectional study","authors":"Gabriella Eliason ,&nbsp;Magnus Ekström ,&nbsp;Scott Montgomery ,&nbsp;Maaike Giezeman ,&nbsp;Mikael Hasselgren ,&nbsp;Christer Janson ,&nbsp;Marta A. Kisiel ,&nbsp;Karin Lisspers ,&nbsp;Anna Nager ,&nbsp;Hanna Sandelowsky ,&nbsp;Björn Ställberg ,&nbsp;Josefin Sundh","doi":"10.1016/j.rmed.2025.108053","DOIUrl":"10.1016/j.rmed.2025.108053","url":null,"abstract":"<div><h3>Background</h3><div>Comorbid conditions and breathlessness are associated with poor outcomes in chronic obstructive pulmonary disease (COPD). We evaluated the associations of comorbid heart disease and depression/anxiety with breathlessness in daily life among people with COPD.</div></div><div><h3>Methods</h3><div>Cross-sectional analysis from the PRAXIS cohort in central Sweden. Data on patient characteristics and the modified Medical Research Council (mMRC) and Dyspnea-12 breathlessness instruments (D-12) were obtained from questionnaires in 2022. Lung function data were collected from record review. Outcome variables were clinically significant breathlessness defined as mMRC≥2 and D-12 total (&gt;2.7), physical (&gt;1.4) and affective (&gt;1.2) scores above published minimal clinical important differences. Associations of heart disease and depression/anxiety with each outcome were analyzed using multivariable Poisson regression adjusted for relevant confounders.</div></div><div><h3>Results</h3><div>In 522 included patients, mMRC ≥2 was present in 59 % and increased D-12 total, physical and affective domain scores in 69 %, 74 %, and 50 %, respectively. Heart disease was independently associated with mMRC (relative risk ratio [95 % confidence interval] 1.34 [1.17–1.53]), D12 physical domain (1.12[1.02–1.24]) and D-12 affective domain (1.20[1.02–1.42]). Depression/anxiety was independently associated with increased D-12 affective domain (1.25[1.04–1.49]). In addition, previous exacerbations and GOLD stage 3–4 were associated with mMRC and D-12, respectively.</div></div><div><h3>Conclusion</h3><div>In COPD, comorbid heart disease is associated with both activity-related breathlessness and with physical and affective domains of breathlessness while depression/anxiety is associated with the affective domain of breathlessness. As the influence of different dimensions of breathlessness may differ according to comorbidity the D-12 instrument adds more information when assessing breathlessness in patients with COPD.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108053"},"PeriodicalIF":3.5,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743568","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}