Annals of the American Thoracic Society最新文献

{"title":"Reply to Holbert and Fraidenburg: Not to Be Forgotten. Pulmonary Vascular Effects of Nonmyeloablative Hematopoietic Cell Transplant for Sickle Cell Disease.","authors":"A Parker Ruhl, Emily M Limerick, Amisha V Barochia, Courtney D Fitzhugh, Matthew M Hsieh","doi":"10.1513/AnnalsATS.202412-1253LE","DOIUrl":"10.1513/AnnalsATS.202412-1253LE","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"628-629"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delving Deeper into Genotypic-Phenotypic Associations in Idiopathic Pulmonary Fibrosis.","authors":"Sydney B Montesi, Ayodeji Adegunsoye","doi":"10.1513/AnnalsATS.202501-130ED","DOIUrl":"10.1513/AnnalsATS.202501-130ED","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"480-482"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric Validation and Determination of the Minimal Clinically Important Difference for the Bronchiectasis Health Questionnaire in Adults with Bronchiectasis.","authors":"Jin-Fu Xu, Surinder S Birring, Yuan-Yuan Li, Ming-Xin Shi, Hai-Wen Lu, Shu-Yi Gu, Jie-Ming Qu, Yong-Hua Gao, Wei-Jie Guan, Nan-Shan Zhong","doi":"10.1513/AnnalsATS.202407-751OC","DOIUrl":"10.1513/AnnalsATS.202407-751OC","url":null,"abstract":"<p><p><b>Rationale:</b> The Bronchiectasis Health Questionnaire (BHQ) is a concise, self-administered, and disease-specific instrument for measuring health-related quality of life in bronchiectasis. <b>Objectives:</b> We sought to investigate the psychometric properties of a simplified Mandarin BHQ and determine the minimum clinically important difference (MCID) as a reliable clinical endpoint for assessing the efficacy of bronchiectasis treatments. <b>Methods:</b> A longitudinal, randomized controlled trial cohort of 357 patients treated with tobramycin inhalation solution or saline inhalation for <i>Pseudomonas aeruginosa</i> infection and a cross-sectional observational cohort of 436 patients with bronchiectasis were analyzed. Psychometric analyses encompassed convergent validity, known-groups validity, internal consistency, test-retest reliability, and responsiveness. Both anchor-based and distribution-based approaches were utilized to calculate the MCID for therapeutic response. <b>Results:</b> There were significant positive correlations between scores on the BHQ and those on the Quality of Life-Bronchiectasis Respiratory Symptom Scale, with correlation coefficients of 0.698 in the trial cohort and 0.567 in the clinical cohort (both <i>P</i>s < 0.0001). Known-groups validity indicated significant differences in BHQ scores stratified by baseline Bronchiectasis Severity Index. BHQ scores correlated modestly with both forced expiratory volume in 1 second percent predicted and exacerbation frequency within the previous year. In the trial cohort, the BHQ demonstrated excellent internal consistency (Cronbach's α = 0.893) and test-retest reliability (intraclass correlation coefficient = 0.853). An 8-point improvement in scores on the Quality of Life-Bronchiectasis Respiratory Symptom Scale corresponded to a mean increase of 5.49 points in BHQ scores after 4-week treatment. The MCID for BHQ was consistently 3 points. <b>Conclusions:</b> The BHQ (MCID: 3 points) represents a clinically meaningful tool for evaluating therapeutic intervention outcomes and patient-centered outcomes in patients with bronchiectasis.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"506-514"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenotypes and Trajectories of Tobacco-exposed Persons with Preserved Spirometry: Insights from Lung Volumes.","authors":"Mehrdad Arjomandi, Siyang Zeng, Igor Barjaktarevic, Eugene R Bleecker, Russell P Bowler, Gerard J Criner, Alejandro P Comellas, David J Couper, Jeffrey L Curtis, Mark T Dransfield, M Bradley Drummond, Spyridon Fortis, MeiLan K Han, Nadia N Hansel, Eric A Hoffman, Robert J Kaner, Richard E Kanner, Jerry A Krishnan, Wassim Labaki, Victor E Ortega, Stephen P Peters, Stephen I Rennard, Christopher B Cooper, Donald P Tashkin, Robert Paine, Prescott G Woodruff","doi":"10.1513/AnnalsATS.202405-527OC","DOIUrl":"10.1513/AnnalsATS.202405-527OC","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Rationale:&lt;/b&gt; Among tobacco-exposed persons with preserved spirometry (TEPSs), we previously demonstrated that different lung volume indices-specifically, elevated total lung capacity (TLC) versus elevated ratio of functional residual capacity to TLC (FRC/TLC)-identify different lung disease characteristics in the COPDGene cohort. &lt;b&gt;Objective:&lt;/b&gt; We sought to determine differential disease characteristics and trajectories associated with lung volume indices among TEPSs in the SPIROMICS cohort. &lt;b&gt;Methods:&lt;/b&gt; We categorized TEPSs (&lt;i&gt;n&lt;/i&gt; = 814) by tertiles (low, intermediate, and high) of TLC or residual volume-to-TLC ratio (RV/TLC) derived from baseline computed tomography images and then examined clinical and spirometric disease trajectories in mutually exclusive categories of participants with high TLC without high RV/TLC ([TLC]&lt;sup&gt;high&lt;/sup&gt;) versus high RV/TLC without high TLC ([RV/TLC]&lt;sup&gt;high&lt;/sup&gt;). We examined differences in computed tomography-measured emphysema (Hounsfield units [HU] ⩽-950; parametric response mapping [PRM] of emphysema), air trapping (HU⩽-856; PRM of functional small airway disease; a disease probability measure for non-emphysematous gas trapping), airway geometry (the mean square root of wall area of a hypothetical airway with 10 mm internal perimeter), respiratory symptoms (on the modified Medical Research Council Dyspnea Scale; COPD Assessment Test [CAT]; St. George's Respiratory Questionnaire [SGRQ]; and Short Form-12 [SF12]), and outcomes (annualized exacerbation rate) between the two categories at baseline and over follow-up time up to 8.5 years, using regression modeling adjusted for age, sex, height, weight, and smoking status (current vs. former smoker) and burden (pack-years). &lt;b&gt;Results:&lt;/b&gt; In TEPSs, the pattern of spirometric disease progression differed between participants with [TLC]&lt;sup&gt;high&lt;/sup&gt; and those with [RV/TLC]&lt;sup&gt;high&lt;/sup&gt;: There was increased forced vital capacity with stable forced expiratory volume in 1 second in participants with [TLC]&lt;sup&gt;high&lt;/sup&gt;, versus unchanged forced vital capacity but nominally decreased forced expiratory volume in 1 second in those with [RV/TLC]&lt;sup&gt;high&lt;/sup&gt;. Compared with participants with [TLC]&lt;sup&gt;high&lt;/sup&gt;, TEPSs with [RV/TLC]&lt;sup&gt;high&lt;/sup&gt; had less emphysema (by HU ⩽-950) but more airway disease (by HU ⩽-856; PRM of functional small airway disease; disease probability measure for gas trapping, and mean square root of wall area of a hypothetical airway with 10 mm internal perimeter), more respiratory symptoms (on the modified Medical Research Council Dyspnea Scale, CAT, SGRQ, and SF12), and more severe exacerbations at baseline. Over an average follow-up of 4.1 ± 2.4 years (range = 0.5-8.5 yr), TEPSs with [RV/TLC]&lt;sup&gt;high&lt;/sup&gt; also had a higher likelihood of developing more severe spirometric disease (preserved ratio impaired spirometry or Global Initiative for Chronic Obstructive Lung Disease Classification 2) and worsening of their","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"494-505"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial Insights into the Ideal Oxygen Saturation Target for Postterm Corrected Age Infants with Bronchopulmonary Dysplasia.","authors":"Sherri Lynne Katz","doi":"10.1513/AnnalsATS.202501-086ED","DOIUrl":"10.1513/AnnalsATS.202501-086ED","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"482-484"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimorbidity and Its Impact in Older U.S. Veterans Newly Treated for Advanced Non-Small Cell Lung Cancer.","authors":"Joseph R Larsen, Chunlei Zheng, Jennifer La, Julie Tsu-Yu Wu, Michael Kelley, J Michael Gaziano, Mary Brophy, Nhan V Do, Dae H Kim, Jane A Driver, Clark DuMontier, Nathanael R Fillmore","doi":"10.1513/AnnalsATS.202406-587OC","DOIUrl":"10.1513/AnnalsATS.202406-587OC","url":null,"abstract":"<p><p><b>Rationale:</b> Older adults make up the majority of patients with advanced non-small cell lung cancer (NSCLC) and often carry multiple other comorbidities (multimorbidity) when initiating treatment. The nature and impact of multimorbidity remain largely unknown, given the limitations of standard count-based comorbidity indices in aging patients and their exclusion from clinical trials. <b>Objectives:</b> Our objective is to identify and define multimorbidity patterns in older U.S. veterans newly treated for advanced NSCLC in the national Veterans Affairs healthcare system between 2002 to 2020, and whether they are associated with mortality and healthcare use. <b>Methods:</b> We measured 63 chronic conditions in 10,160 veterans aged ⩾65 years newly treated for NSCLC in the national Veterans Affairs healthcare system from 2002 to 2020. Latent class analysis was used to identify patterns of multimorbidity among these conditions, with final patterns determined on the basis of model fit and clinical meaningfulness. Kaplan-Meier and Cox proportional hazards regression analyses were used to evaluate the association of multimorbidity patterns with overall survival (primary outcome) and with emergency department visits and unplanned hospitalizations (secondary outcomes). <b>Results:</b> Five multimorbidity patterns arose from the latent class analysis, with overall survival varying across patterns (log-rank two-sided <i>P</i> < 0.001). Veterans with metabolic diseases (24.7% of all patients; hazard ratio [HR] [95% confidence interval (CI)], 1.10 [1.04-1.16]), psychiatric and substance use disorders (16.0%; HR [95% CI], 1.17 [1.10-1.24]), cardiovascular disease (14.4%; HR [95% CI], 1.22 [1.15-1.30]), and multisystem impairment (10.7%; HR [95% CI], 1.36 [1.26-1.46]) had a higher hazard of death than veterans with common conditions of aging beyond their NSCLC (34.2%, reference), controlling for age, sex, race, days between diagnosis and treatment, date of diagnosis, and NSCLC stage and histology. Associations held after adjusting for the count-based Charlson comorbidity index. Multimorbidity patterns were also independently associated with emergency department visits and unplanned hospitalizations. <b>Conclusions:</b> Our findings reveal that the numerous chronic conditions present in older veterans with late-stage NSCLC cluster together into distinct multimorbidity patterns; the nature of conditions in these patterns carries value beyond their number.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"598-608"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who \"Needs\" Long-Term Oxygen? How Little We Really Know.","authors":"Richard Casaburi, Yves Lacasse","doi":"10.1513/AnnalsATS.202501-101ED","DOIUrl":"10.1513/AnnalsATS.202501-101ED","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"484-485"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association between All-Cause Mortality and Obstructive Sleep Apnea in Adults: A U-Shaped Curve.","authors":"Mehrnaz Azarian, Amin Ramezani, Amir Sharafkhaneh, Arash Maghsoudi, Meir Kryger, Robert J Thomas, M Brandon Westover, Javad Razjouyan","doi":"10.1513/AnnalsATS.202407-755OC","DOIUrl":"10.1513/AnnalsATS.202407-755OC","url":null,"abstract":"<p><p><b>Rationale:</b> The relationship between sleep apnea (SA) and mortality remains a topic of debate. <b>Objectives:</b> We explored the relationship between the severity of SA and mortality and the effect of age on this association. <b>Methods:</b> Using a veterans' database, we extracted an apnea-hypopnea index (AHI) from physician interpretations of sleep studies by developing a natural language processing pipeline (with 944 manually annotated notes), which achieved more than 85% accuracy. We categorized the participants into no SA (n-SA; AHI, <5), mild to moderate SA (m-SA; 5 ⩽ AHI < 30), and severe SA (s-SA; AHI, ⩾30). We propensity-matched the m-SA and s-SA categories with n-SA on the basis of age, sex, race, ethnicity, body mass index, and 38 components of the Elixhauser Comorbidity Index. Using logistic regression, we estimated the odds ratio (OR) for all-cause mortality using m-SA as a reference. Also, we stratified the findings on the basis of age: young, ⩽40; middle aged, >40 and <65; and older, ⩾65 adults. <b>Results:</b> We extracted the AHI on 179,121 propensity-matched participants (mean age = 45.85 [SD = 14.1]; BMI = 30.15 ± 5.37 kg/m²; male, 79.09%; White, 64.5%). All-cause mortality rates among three AHI categories showed a U-shaped curve (11.55%, 7.07%, and 8.15% for n-SA, m-SA, and s-SA, respectively), regardless of age group. Compared with m-SA, the odds of all-cause mortality in n-SA (OR, 1.72; 95% confidence interval = 1.65-1.79) and s-SA (OR, 1.17; 95% confidence interval = 1.12-1.22) were higher. Stratifying by age yielded consistent findings. <b>Conclusions:</b> All-cause mortality showed a U-shaped association with the AHI. Further investigations to understand the underlying mechanisms of this phenomenon are warranted.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"581-590"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Preserved-Ratio Impaired Spirometry (PRISm) with All-Cause Mortality: A Longitudinal Cohort Study.","authors":"Yunjoo Im, Taeyun Kim, Jung Hye Hwang, Hyunsoo Kim, Seokmin Hyun, So Rae Kim, Sun Hye Shin, Juhee Cho, Danbee Kang, Hye Yun Park","doi":"10.1513/AnnalsATS.202403-250OC","DOIUrl":"10.1513/AnnalsATS.202403-250OC","url":null,"abstract":"<p><p><b>Rationale:</b> Numerous studies indicate that preserved-ratio impaired spirometry (PRISm) is associated with adverse clinical outcomes. However, the impact of PRISm severity, particularly in regard to forced vital capacity (FVC), on mortality risk remains unclear. <b>Objectives:</b> To determine whether PRISm was associated with mortality and to identify specific groups with particularly increased mortality rates. <b>Methods:</b> This retrospective study enrolled individuals aged >40 years who underwent comprehensive health screening at the Center for Health Promotion at Samsung Medical Center between 2003 and 2020. PRISm was characterized by a ratio of forced expiratory volume in 1 second to FVC of at least 0.7 and forced expiratory volume in 1 second <80% of predicted values. Participants were classified into three groups: normal lung function, PRISm with normal FVC, and PRISm with low FVC (FVC <80% predicted). We compared all-cause mortality rates using the Kaplan-Meier method and the Cox proportional hazard ratio model. <b>Results:</b> Among 106,458 individuals, 86,208 exhibited normal lung function, 6,249 had PRISm with normal FVC, and 14,001 had PRISm with low FVC. Over a median follow-up of 10.1 years, 2,219 participants died. Individuals with PRISm experienced a higher cumulative mortality rate compared with those with normal lung function (39 vs. 16 per 10,000 person-years; adjusted hazard ratio, 1.43; 95% confidence interval [CI], 1.31-1.56). The fully adjusted hazard ratios for all-cause mortality in PRISm with normal and low FVC were 1.25 (95% CI, 1.03-1.52) and 1.47 (95% CI, 1.33-1.62) relative to those with normal lung function, respectively. <b>Conclusions:</b> PRISm is associated with an increased risk of death, particularly when accompanied by low FVC.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"486-493"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in the Treatment of Allergic Bronchopulmonary Aspergillosis.","authors":"Brandon Pang, Christopher M Kearney, Anica C Law, Nicholas A Bosch","doi":"10.1513/AnnalsATS.202403-306RL","DOIUrl":"10.1513/AnnalsATS.202403-306RL","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"620-623"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}