Respiratory Medicine and Research最新文献

{"title":"Pulmonary arterial stiffness as the main correlate of effective arterial elastance in pre- and post-capillary pulmonary hypertension","authors":"Denis Chemla ,&nbsp;Antoine Beurnier ,&nbsp;Christian Gerges ,&nbsp;Xavier Jaïs ,&nbsp;Athenaïs Boucly ,&nbsp;Laurent Savale ,&nbsp;Olivier Sitbon ,&nbsp;Marc Humbert ,&nbsp;David Montani ,&nbsp;Philippe Hervé","doi":"10.1016/j.resmer.2025.101204","DOIUrl":"10.1016/j.resmer.2025.101204","url":null,"abstract":"<div><h3>Background</h3><div>A simplified estimate of pulmonary effective arterial elastance (Ea_sPAP), defined as systolic pulmonary artery (PA) pressure divided by stroke volume (SV), is increasingly used to quantify total PA load and its coupling with right ventricle in pulmonary hypertension (PH), with elevated Ea_sPAP associated with worse prognosis. Although arterial elastance is thought to depend more on pulmonary vascular resistance (PVR) than on stiffness, the value of this simplified, clinically derived estimate remains unclear.</div></div><div><h3>Methods</h3><div>This retrospective invasive study included 236 adults diagnosed with idiopathic pulmonary arterial hypertension (<em>n</em> = 118) or post-capillary PH (<em>n</em> = 118), matched for age, sex, and mean PA pressure (mPAP). Total PA stiffness was defined as PA pulse pressure/SV.</div></div><div><h3>Results</h3><div>In the overall population (63 % women, median age 70 years, mPAP 38 mmHg), Ea_sPAP correlated most strongly with stiffness (Spearman <em>ρ</em>=0.95). The same was observed in both groups, with regression lines showing similar slopes and intercepts. These correlations were explained by the superimposable linear relationships between systolic and pulse pressures, together with the shared SV in the formulas. Ea_sPAP was less strongly associated with PVR (<em>ρ</em>=0.83) (<em>P</em> &lt; 0.0001), with differing slopes and intercepts between groups. Similar results were observed when downstream pressure was included in elastance calculation, and in the youngest age tertile.</div></div><div><h3>Conclusions</h3><div>In PH patients, Ea_sPAP most closely correlated with the PA pulse pressure/SV ratio, the standard clinical estimate of total PA stiffness. This overlap among clinical indices of PA load warrants recognition, suggesting right ventricular responses may be mainly driven by pulsatile load, with potential therapeutic implications.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"88 ","pages":"Article 101204"},"PeriodicalIF":1.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259423","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":"Rapid and extensive calcification of pulmonary arteries","authors":"Sahbi Guezara ,&nbsp;Vincent Cottin ,&nbsp;Giulia Francese ,&nbsp;Mohamed Bakloul ,&nbsp;Sara Boccalini ,&nbsp;Ségolène Turquier","doi":"10.1016/j.resmer.2025.101189","DOIUrl":"10.1016/j.resmer.2025.101189","url":null,"abstract":"","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"88 ","pages":"Article 101189"},"PeriodicalIF":1.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750470","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":"Diaphragm dysfunction evaluated by electroneuromyography in patients with interstitial lung disease (ILD), risks factors and impact on mortality: a retrospective observational study","authors":"Jules Milesi ,&nbsp;Sophie Ng Wing Tin ,&nbsp;Thomas Gille ,&nbsp;Hilario Nunes ,&nbsp;Simon Chauveau ,&nbsp;Carole Planès ,&nbsp;Guillaume Robbe ,&nbsp;Yurdagül Uzunhan ,&nbsp;Lucile Sesé","doi":"10.1016/j.resmer.2025.101196","DOIUrl":"10.1016/j.resmer.2025.101196","url":null,"abstract":"<div><h3>Introduction</h3><div>Diaphragmatic dysfunction (DD) plays a significant role in dyspnea, quality of life, and prognosis in various respiratory diseases. However, its characterization in Interstitial Lung Diseases (ILDs) remains limited. This study aimed to characterize ILD patients with probable DD using diaphragmatic electroneuromyography (dENMG) and analysis of the diaphragm's compound muscle action potential (CMAP), and to determine predictive factors of DD and its prognostic impact.</div></div><div><h3>Methods</h3><div>A retrospective monocentric study was conducted in our center, including all consecutive ILD patients who underwent diaphragm evaluation with ENMG between May 2018 and September 2023. Clinical data, dENMG, and other assessments were collected. Association between abnormal diaphragm’s CMAP and ILD characteristics were analyzed using logistic regression. Survival was analyzed using Kaplan-Meier curves and cox model adjusted for age and sex.</div></div><div><h3>Results</h3><div>Between May 2018 and September 2023, thirty-seven ILD patients underwent an dENMG for suspected DD. Connective Tissue Disease-associated ILD (CTD-ILD) [28 (76 %)] was the most common ILD-subtype. Thirteen (35 %) had a DD according to dENMG. Patients with DD were predominantly older males, had a higher prevalence of coronary artery disease (CAD), and had less non-specific interstitial pneumonia (NSIP) pattern compared to patients without DD. The prognosis appeared to be worse in the DD group, with reduced survival [mean 29.3 (± 17.2) <em>p</em> = 0.04 vs 31.3 months (± 18.3)].</div></div><div><h3>Discussion</h3><div>In a French referral center for ILDs, suspicion of associated DD concerned only a small proportion of ILD patients, mainly with CTD-ILD. Among those, only a third had DD suspected by a dENMG and abnormal diaphragm’s CMAP. DD appears to be associated with unfavorable outcomes, although further research with larger cohorts is warranted.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"88 ","pages":"Article 101196"},"PeriodicalIF":1.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889663","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":"Impact of the COVID-19 pandemic on lung cancer diagnosis, treatment, mortality, and survival in Belgium: A population-based study","authors":"Hanne Peirelinck ,&nbsp;Hanna M. Peacock ,&nbsp;Geert Silversmit ,&nbsp;Thierry Berghmans ,&nbsp;Paul De Leyn ,&nbsp;Ingel Demedts ,&nbsp;Xavier Geets ,&nbsp;Yolande Lievens ,&nbsp;Harlinde De Schutter","doi":"10.1016/j.resmer.2025.101205","DOIUrl":"10.1016/j.resmer.2025.101205","url":null,"abstract":"<div><h3>Background</h3><div>We evaluated the impact of COVID-19 on the care pathway and outcomes for patients diagnosed with lung cancer in 2020 in Belgium.</div></div><div><h3>Methods</h3><div>Lung cancer patients diagnosed in 2017–2020 were extracted from the nationwide Belgian Cancer Registry database. Characteristics and treatment of patients in 2020 were compared with 2017–2019 at semester level (January-June: S1; July-December: S2). 90-day post-operative mortality and relative survival (RS) at 1 and 3 years for 2020 were compared with the 2017–2019 trend.</div></div><div><h3>Results</h3><div>The study included 29,721 patients diagnosed with lung cancer in 2017–2020. Patients diagnosed in 2020 had a poorer WHO Performance status and more often distant metastases compared to the corresponding semester in 2017–2019. In 2020 S2, there was slightly less surgery performed in patients with early-stage (I-II) lung cancer in favour of radiotherapy (RT) (surgery:4.7 percent-points, RT +6.0 percent-points, <em>p</em> = 0.001). RT courses had a shorter median duration (S1:4 days; S2:4 days) and lower median number of fractions (S1:5; S2:5). The unadjusted 90-day post-operative mortality increased, but this increase was no longer significant when adjusting for case-mix (unadjusted: Odds ratio (OR) =1.85 [1.05–3.24]; adjusted: (OR 1.78 [0.99–3.21]). There was no significant change in RS at 1 and 3 years, with or without case-mix adjustment (unadjusted: 1-year excess hazard ratio (EHR)=1.06 [1.00–1.12], 3-year EHR=1.05 [1.00–1.11]; adjusted: 1-year EHR=1.02 [0.96–1.08], 3-year EHR=1.02 [0.96–1.07]).</div></div><div><h3>Conclusion</h3><div>Lung cancer patients in Belgium experienced only minor changes in their care pathway during the COVID-19 pandemic. The changes in stage distribution and the increase in 90-day postoperative mortality warrant monitoring of long-term outcomes.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"88 ","pages":"Article 101205"},"PeriodicalIF":1.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214215","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":"Forced vital capacity reduction severity in pulmonary fibrosis and post-lung transplantation outcomes","authors":"Manon Levêque ,&nbsp;Julien Bermudez ,&nbsp;Ana Nieves ,&nbsp;Florence Daviet ,&nbsp;Antoine Roux ,&nbsp;Xavier Demant ,&nbsp;Benjamin Renaud-Picard ,&nbsp;Jérôme Le Pavec ,&nbsp;Hervé Mal ,&nbsp;Thomas Villeneuve ,&nbsp;Jean-François Mornex ,&nbsp;Loïc Falque ,&nbsp;Véronique Boussaud ,&nbsp;Christiane Knoop ,&nbsp;Adrien Tissot ,&nbsp;Martine Reynaud-Gaubert ,&nbsp;Benjamin Coiffard ,&nbsp;the COLT consortium","doi":"10.1016/j.resmer.2025.101158","DOIUrl":"10.1016/j.resmer.2025.101158","url":null,"abstract":"<div><h3>Background</h3><div>The ISHLT guidelines recommend early referral to a lung transplantation (LTx) center for patients with interstitial lung disease (ILD) due to the unpredictable course. To our knowledge, no study has assessed the impact of forced vital capacity (FVC) reduction severity on LTx outcomes in ILD. This study aims to determine whether the severity of FVC reduction is associated with post-transplant outcomes in ILD.</div></div><div><h3>Methods and Results</h3><div>Recipients from the French multicentric COLT cohort who underwent lung transplantation for ILD were included in this study. FVC was assessed to determine if the severity of its reduction is associated with post-transplant outcomes. 311 recipients were included in the study. FVC was identified as a significant risk factor for mortality at one year in multivariate analysis (<em>p</em> = 0.003). The ROC curve for FVC estimated the probability of death at one year with an area under the curve of 64 % (95 % confidence interval 57–71 %) and defined an optimal FVC threshold of 46 %. Recipients with an FVC ≤46 % were more likely to be listed as emergency cases, had lower FVC at one year, and exhibited reduced short- and long-term survival.</div></div><div><h3>Conclusions</h3><div>The severity of pre-transplant FVC reduction is a risk factor for poorer post-transplant outcomes. The findings should stimulate discussion about benefits of LTx for patients with lower FVC. An FVC threshold of ≤46 % should be considered in discussions about lung transplantation indications, decisions regarding single lung transplantation, and the selection of smaller donor lungs. Respirologists managing patients with ILD should consider early referral to a LTx center.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"87 ","pages":"Article 101158"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387235","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":"Long-acting muscarinic antagonists (LAMA) in asthma: What is the best strategy?","authors":"Guillaume Mahay ,&nbsp;Maeva Zysman ,&nbsp;Nicolas Guibert ,&nbsp;Cindy Barnig ,&nbsp;Laurent Guilleminault ,&nbsp;Clairelyne Dupin","doi":"10.1016/j.resmer.2025.101157","DOIUrl":"10.1016/j.resmer.2025.101157","url":null,"abstract":"<div><div>The use of long-acting muscarinic antagonists (LAMA) in asthma is supported by their mechanism of action and evidence of drug synergy with inhaled corticosteroids ± long-acting β-agonists. This review discusses the scientific rationale, clinical data, and recommendations for the use of LAMA in the asthma therapeutic strategy. Adding a LAMA to a dual therapy with an inhaled corticosteroid and long-acting β-agonist has been shown to reduce exacerbations, increase asthma control, and improve quality of life, with a good safety profile. In addition, using a single inhaler device containing multiple drugs enhances patients’ adherence to therapy. Some predictive factors of the efficacy of this triple therapy have been suggested in the literature: patients with a history of at least one exacerbation within the past 12 months, male patients, those younger than 65 years, and non-smokers have been reported to have a greater improvement from baseline forced expiratory volume in 1 second (FEV1) compared with patients without these characteristics, while patients with high bronchial hyperresponsiveness and persistent airway limitations (PAL) seem to show better gains in the exacerbation rate. However, eosinophil levels do not seem to predict the efficacy of LAMA. The role and long-term benefits of LAMA combined with biologic therapy in severe asthma remain uncertain, with more clinical data needed.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"87 ","pages":"Article 101157"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387236","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":"Progressive course of anti-nuclear matrix protein-2 (NXP-2) positive-interstitial lung disease","authors":"Bess M. Flashner ,&nbsp;Ryosuke Imai ,&nbsp;Andrew J. Synn ,&nbsp;Julia K. Munchel ,&nbsp;Lida P. Hariri ,&nbsp;Fiona K. Gibbons ,&nbsp;Sydney B. Montesi ,&nbsp;Barry S. Shea ,&nbsp;Mary B. Rice ,&nbsp;Rene S. Bermea ,&nbsp;Robert W. Hallowell","doi":"10.1016/j.resmer.2025.101170","DOIUrl":"10.1016/j.resmer.2025.101170","url":null,"abstract":"<div><h3>Background</h3><div>Evaluating the etiology of interstitial lung disease (ILD) commonly involves ordering a myositis panel containing myositis-specific antibodies (MSAs), including anti-NXP-2. However, little is known about the presentation of patients with ILD and anti-NXP-2 positivity. We sought to define the course of anti-NXP-2-positive ILD in order to guide prognosis and potential treatment strategies.</div></div><div><h3>Methods</h3><div>We performed a retrospective chart review of patients with positive anti-NXP-2 antibodies who presented to two ILD referral centers in Boston, MA between 2012 and 2024. Patients were identified by query of the electronic medical record for patients positive for anti-NXP-2. We included those anti-NXP-2 positive patients with ILD on chest computed tomography (CT). Data regarding clinical presentation and disease course were abstracted from the medical record. For patients following longitudinally in the ILD clinic, we conducted survival analyses for ILD progression (composite of PFT progression, hospitalization, or death) using Kaplan-Meier curves and log-rank tests. Additionally, we used a Cox proportional-hazards model, adjusting for age, gender, forced vital capacity (FVC) at baseline, and immunosuppression to calculate hazard ratios. ILD patients with MSA-positive, NXP-2-negative ILD served as the comparator group.</div></div><div><h3>Results</h3><div>31 patients were identified (mean 70 years, SD 9). Three were diagnosed with dermatomyositis (DM) prior to presentation, but the remaining had ILD as the only manifestation of connective tissue disease. Most (97%) patients were symptomatic with dyspnea and/or cough at presentation. Other autoantibody positivity was common; only 42% were positive for anti-NXP-2 alone without positivity for other autoimmune serologies, including MSAs known to be associated with ILD. Clinical follow up data were available for 28 patients for a median follow up period of 24 months (range &lt;1 month-13 years). A majority (61%) were treated with immunosuppression, antifibrotics, or both. Over one third experienced acute exacerbation of ILD or death (<em>N</em> = 11, 35%). Progression-free survival was similar to that of other MSA-positive ILD patients, regardless of whether anti-NXP-2 was positive alone or co-positive for other autoantibodies.</div></div><div><h3>Conclusions</h3><div>We present the largest single series of anti-NXP-2-positive ILD. Anti-NXP-2-positive ILD can occur in the absence of DM/PM and can manifest as progressive pulmonary disease that is similar to other MSA-positive ILDs.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"87 ","pages":"Article 101170"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839011","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":"The effect of concurrent acetylsalicylic acid on hemorrhagic complications during percutaneous image-guided lung biopsy","authors":"Julie Tronchetti ,&nbsp;Paul Habert ,&nbsp;Thibault Agripnidis ,&nbsp;Katia Chaumoitre ,&nbsp;Noémie Resseguier ,&nbsp;Anh Thu Nguyen ,&nbsp;Jean-Yves Gaubert ,&nbsp;Hervé Dutau ,&nbsp;Philippe Astoul ,&nbsp;Julien Guinde","doi":"10.1016/j.resmer.2024.101150","DOIUrl":"10.1016/j.resmer.2024.101150","url":null,"abstract":"<div><h3>Background</h3><div>CT-guided trans-thoracic lung biopsy (CT-TTLB) is efficient and widely used to diagnose pulmonary nodules. After pneumothorax, the second most frequent complication is hemoptysis, which can be life-threatening. These patients often have comorbidities and are on acetylsalicylic-acid (ASA) therapy. The aim of this study was to assess ASA as a risk factor for hemoptysis or severe hemoptysis following CT-TTLB.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed consecutive patients undergoing CT-TTLB from 2 centers between 01/2018 and 01/2021. Exclusion criteria were nodules with a pleural contact or a contraindication to lung puncture. Clinical and imaging data were recorded such as age, gender, comorbidities, hemoptysis (every blood spit), severe hemoptysis (&gt;200 mL / oxygen need&gt;10L/min / intervention or resuscitation / death), nodule size, puncture depth, emphysema, nodule location, patient position and histology. Lung parenchymal hemorrhage (LPH) was quantified in cm³ on CT after biopsy. Univariate and multivariate analysis were performed with a logistic regression model, without and with propensity match score, to identify variables associated with hemoptysis and severe hemoptysis.</div></div><div><h3>Results</h3><div>Four-hundred-and-one patients were analyzed, 106 and 295 in the ASA or the control group respectively. In multivariate analysis, ASA use was a risk factor for severe hemoptysis (OR=4.5; 95 %CI[1.3–15.9]) but not for hemoptysis (OR=1.7; 95 %CI[0.5–3.1]), persisting after matching. There was no difference for LPH between the ASA and the control sub-groups (median (IQR)) 5.2cm³ (15.3) vs 3.1cm³ (11.5) <em>p</em> = 0.2).</div></div><div><h3>Conclusions</h3><div>Treatment with ASA did not increase the risk of all hemoptysis occurrence after CT-TTLB but was a risk factor for severe hemoptysis.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"87 ","pages":"Article 101150"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104864","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":"Ultrasound-guided pleural biopsy (USGB) outcomes: The impact of respiratory-led one stop shop","authors":"Shyun Ping Tiong,&nbsp;John De Jesus,&nbsp;Tashi Playle,&nbsp;Emily Harvey,&nbsp;Michael Ball,&nbsp;Siyamini Vythilingam,&nbsp;Rachelle Asciak","doi":"10.1016/j.resmer.2025.101167","DOIUrl":"10.1016/j.resmer.2025.101167","url":null,"abstract":"","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"87 ","pages":"Article 101167"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725916","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":"Role of narrow band imaging in assessing bronchial mucosal hypervascularization in COVID-19 patients","authors":"Damien Basille ,&nbsp;Bénédicte Toublanc ,&nbsp;Géraldine François ,&nbsp;Isabelle Mayeux ,&nbsp;Claire Poulet ,&nbsp;Lola Soriot ,&nbsp;Mélanie Drucbert ,&nbsp;Nour Ahmad ,&nbsp;Claire Andrejak ,&nbsp;Daniel Rodenstein ,&nbsp;Yazine Mahjoub ,&nbsp;Vincent Jounieaux","doi":"10.1016/j.resmer.2025.101155","DOIUrl":"10.1016/j.resmer.2025.101155","url":null,"abstract":"<div><h3>Background</h3><div>SARS-CoV-2 virus which targets the lung vasculature is supposed to affect both pulmonary and bronchial arteries. This study evaluated the tracheobronchial vascularization density observed with narrow band imaging (NBI) in patients hospitalized for COVID-19 pneumonia. To determine if the observed changes were specific of COVID-19 patients, the procedure was also performed in non-COVID-19 patients.</div></div><div><h3>Methods</h3><div>Thirty patients included in this monocentric, prospective study underwent videobronchoscopy using both white light and NBI: 10 with a COVID-19 infection, 10 with a non-COVID-19 pulmonary infection and 10 with a peripheral pulmonary nodule. The tracheobronchial vascular density observed through NBI was rated by two blinded pneumologists at three levels (carina, right main bronchus and left main bronchus).</div></div><div><h3>Results</h3><div>When compared to the two other groups, a significant increase of the tracheobronchial vascularization was found in COVID-19 patients. The median tracheobronchial vascularization global score obtained with NBI (out of 15 points) was: 10 [9 – 13] in the COVID-19 group, 5 [4 – 10] in the non-COVID-19 group (<em>p</em> &lt; 0.001) and 6 in the Nodule group [4 – 9] (<em>p</em> = 0.002). Using a weighted Cohen's Kappa coefficient, we observed a good agreement between the two raters for the evaluation of the tracheobronchial vascularization score (κ = 0.75 [0.65–0.83]); <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Videobronchoscopy with NBI in COVID-19 patients showed diffuse changes in tracheobronchial vascularization. We suggest that such bronchial hypervascularisation with dilated vessels contributes, at least in part, to the intrapulmonary right to left shunt that characterized the COVID-19 related Acute Vascular Distress Syndrome (AVDS).</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"87 ","pages":"Article 101155"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025365","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}