CHEST pulmonary最新文献

{"title":"Managing Silicosis in the United States","authors":"Michael R. Kahn MD, MA Teaching ,&nbsp;Chanidapa Klinhom MD ,&nbsp;William D. Wallace MD ,&nbsp;Sarah Edminster DO ,&nbsp;Toby M. Maher MD, PhD ,&nbsp;Luis E. Huerta MD, MSCI","doi":"10.1016/j.chpulm.2024.100103","DOIUrl":"10.1016/j.chpulm.2024.100103","url":null,"abstract":"<div><div>Once considered a disease of the past in developed countries, silicosis is making a worrying comeback as an irreversible and potentially fatal pulmonary disease in the United States. Silicosis has been an unfortunate mainstay of respiratory disease in the developing world, but modern industries, such as stone countertop fabrication, are causing a public health crisis in the United States. This recent uptick in silicosis cases, led by the first recent case in the United States in a stone countertop worker in 2015, may be just the beginning. Because patients seem to present at a younger age with more severe disease than prior cohorts with silicosis, we have found an absence of clear guidelines and standards of care for patients with severe silicosis, particularly for those with end-stage disease. Drawing on experiences from patients with silicosis at the Los Angeles General Medical Center/University of Southern California, we have compiled a clinical review of the topic and provide our institutional approach to screening, examination, diagnosis, management, and, if necessary, referral for lung transplantation. In this “How I Do It,” we share our experience from California to equip clinicians with tools to better diagnose silicosis, recognize end-stage disease, and support patients to lower the morbidity and mortality of this entirely preventable pneumoconiosis.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 4","pages":"Article 100103"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significance of Normal Lung Volume on Quantitative CT Imaging Analysis in Group 1 and Group 3 Pulmonary Hypertension","authors":"Tadasu Okaya MD. PhD ,&nbsp;Ayako Shigeta MD. PhD ,&nbsp;Nobuhiro Tanabe MD. PhD ,&nbsp;Koichiro Tatsumi MD. PhD ,&nbsp;Hajime Yokota MD. PhD ,&nbsp;Akira Nishiyama MD. PhD ,&nbsp;Akira Naito MD. PhD ,&nbsp;Ayumi Sekine ,&nbsp;Toshihiko Sugiura MD. PhD ,&nbsp;Seiichiro Sakao MD. PhD ,&nbsp;Takuji Suzuki MD. PhD","doi":"10.1016/j.chpulm.2024.100062","DOIUrl":"10.1016/j.chpulm.2024.100062","url":null,"abstract":"<div><h3>Background</h3><div>Patients with concurrent pulmonary hypertension (PH) and parenchymal lung diseases have a high risk of mortality. However, whether their outcomes are related to low normal lung volume (NLV) resulting from parenchymal lung diseases on chest high-resolution CT (HRCT) imaging remains unknown.</div></div><div><h3>Research Question</h3><div>Would NLV on quantitative HRCT imaging affect disease behavior in patients with PH?</div></div><div><h3>Study Design and Methods</h3><div>This retrospective observational study evaluated patients with physician-diagnosed group 1 and group 3 PH among 1,471 patients who underwent right heart catheterization. Using a 3-dimensional image analysis system for HRCT imaging, the percentage of NLV (–950 to –600 Hounsfield units) to the whole lungs (%NLV) was calculated. The optimal cutoff point of %NLV for predicting survival was examined using the receiver operating characteristic (ROC) curve. The Kaplan-Meier method and Cox proportional hazards regression were used to detect the association between %NLV and prognosis. Multivariable logistic regression was performed to examine the association of %NLV with response to pulmonary vasodilators.</div></div><div><h3>Results</h3><div>Overall, 157 patients (mean age, 53.1 ± 17.6 years; sex, n = 111 [70.7%] female patients) were included. ROC curve analysis showed that the optimal cutoff of %NLV for predicting survival was 83.2%. The patients with %NLV of ≥ 83.2% showed significantly higher 5-year survival than that of those with %NLV of &lt; 83.2% (81.7% vs 36.6%; <em>P &lt; .</em>0001). Multivariable logistic regression analysis revealed %NLV of &lt; 83.2% as an independent prognostic factor (hazard ratio, 2.49 [95% CI, 1.14–5.44]; <em>P = .</em>022). Responders showed significantly higher %NLV than nonresponders (90.0 ± 5.1% vs 84.7 ± 9.2%; <em>P = .</em>0002). Multivariable regression analysis showed that only high %NLV predicted response (OR, 1.12 [95% CI, 1.01–1.23]; <em>P = .</em>016).</div></div><div><h3>Interpretation</h3><div>Quantitative CT imaging analysis might allow numerical quantification of the lung condition and vasodilator-treatable area beyond subjective visual assessment in patients with PH. The %NLV could be a novel predictor of prognosis and treatment response in these patients.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 4","pages":"Article 100062"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141023579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study Design and Rationale for the TETON-PPF Phase 3, Randomized, Controlled Clinical Trial of Inhaled Treprostinil in the Treatment of Progressive Pulmonary Fibrosis","authors":"Steven D. Nathan MD ,&nbsp;Juergen Behr MD ,&nbsp;Vincent Cottin MD ,&nbsp;Lisa Lancaster MD ,&nbsp;Peter Smith PharmD ,&nbsp;CQ Deng PhD ,&nbsp;Natalie Breytenbach PharmD ,&nbsp;Heidi Bell MD ,&nbsp;Leigh Peterson PhD ,&nbsp;Kevin R. Flaherty MD","doi":"10.1016/j.chpulm.2024.100124","DOIUrl":"10.1016/j.chpulm.2024.100124","url":null,"abstract":"<div><h3>Background</h3><div>Progressive pulmonary fibrosis (PPF) affects a group of patients with various underlying interstitial lung diseases (ILDs) who develop progressive fibrosis and exhibit a similar disease course to patients with idiopathic pulmonary fibrosis (IPF). In PPF, fibrosis becomes self-sustaining and behaves similarly across ILDs, irrespective of the initial trigger, with patients developing worsening respiratory symptoms, lung function, and quality of life and increased mortality despite usual treatments for the underlying ILD. Inhaled treprostinil has demonstrated improvements in FVC and reduced exacerbations of underlying lung disease in patients with pulmonary hypertension associated with ILD in post hoc analyses of a phase 3 study (Safety and Efficacy of Inhaled Treprostinil in Adult PH With ILD Including CPFE [INCREASE]) and its open-label extension. These results and preclinical evidence of treprostinil’s antifibrotic activity support its investigation in the treatment of PPF. Inhaled treprostinil is also being investigated for the treatment of IPF in the Study of Efficacy and Safety of Inhaled Treprostinil in Subjects with Idiopathic Pulmonary Fibrosis (TETON) and the Multinational Study of Efficacy and Safety of Inhaled Treprostinil in Subjects With Idiopathic Pulmonary Fibrosis (TETON-2).</div></div><div><h3>Research Question</h3><div>Does inhaled treprostinil improve absolute FVC over 52 weeks in patients with PPF?</div></div><div><h3>Study Design and Methods</h3><div>The Study of the Efficacy and Safety of Inhaled Treprostinil in Subjects With Progressive Pulmonary Fibrosis (TETON-PPF) is a 52-week, randomized, double-blind, placebo-controlled, phase 3 study enrolling 698 patients. Eligible patients must have a diagnosis of PPF (other than IPF) with radiographic fibrosis of &gt; 10% extent and FVC ≥ 45%. Background use of pirfenidone or nintedanib is allowed. The primary end point is change in absolute FVC at week 52. Secondary end points include time to first clinical worsening, time to first acute exacerbation of ILD, overall survival, change in % predicted FVC, change in the King’s Brief Interstitial Lung Disease Questionnaire, and change in lung diffusion capacity. Safety parameters include adverse events, hospitalizations, oxygenation, and laboratory parameters.</div></div><div><h3>Results</h3><div>The study was initiated in October 2023 and will continue until 698 patients enroll.</div></div><div><h3>Interpretation</h3><div>When completed, TETON-PPF will confirm whether inhaled treprostinil is safe and effective for the treatment of PPF.</div></div><div><h3>Clinical Trial Registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>; No.: <span><span>NCT05943535</span><svg><path></path></svg></span>; URL: <span><span>www.clinicaltrials.gov</span><svg><path></path></svg></span></div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 2","pages":"Article 100124"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143899549","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":"Sleep Parameters of Breathing and Cognitive Function in a Diverse Hispanic/Latino Cohort","authors":"Kevin A. González MS ,&nbsp;Wassim Tarraf PhD ,&nbsp;Shanmin Sultana BS ,&nbsp;Barbara Junco MS ,&nbsp;Eena Kosik BS ,&nbsp;Bradley Voytek PhD ,&nbsp;Hector M. González PhD ,&nbsp;Alberto R. Ramos MD, MSPH, FAASM","doi":"10.1016/j.chpulm.2024.100102","DOIUrl":"10.1016/j.chpulm.2024.100102","url":null,"abstract":"<div><h3>Background</h3><div>Sleep-disordered breathing (SDB) is common and associated with worse cardiovascular and brain health. Hispanic/Latino individuals are at increased risk for SDB. OSA is the most studied SDB; it is characterized by apnea-hypopnea events and has been linked to adverse vascular health and cognitive sequelae. Less is known about upstream factors such as parameters of breathing. Breathing dynamics such as breathing rate and breathing rate variability have been linked to changes in mood and oscillatory brain activity. Their relationships with cognitive performance, particularly in diverse and understudied Hispanic/Latino communities, are unknown.</div></div><div><h3>Research Question</h3><div>What is the association between parameters of breathing and cognitive outcomes?</div></div><div><h3>Study Design and Methods</h3><div>The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a prospective study of diverse Hispanic/Latino participants. Individuals were given a home sleep apnea device for in-home sleep testing. Breathing information was extracted from the cannula channel, and parameters of breathing were calculated by using bycycle, a novel tool for time series analysis. A total of 6,737 individuals were included in the study.</div></div><div><h3>Results</h3><div>Faster breathing rate was linked with worse domain-specific and global cognitive performance (b_global = –0.011; <em>P</em> &lt; .01), and breathing rate variability was associated with worse global cognitive performance (β_global = –0.022; <em>P</em> &lt; .05). In interaction models, breathing rate variability was found to be significantly associated with worse verbal fluency and global cognitive performance in women but not in men.</div></div><div><h3>Interpretation</h3><div>Parameters of breathing are novel methods for understanding SDB and cognitive function. These results also suggest that faster breathing rate variability in women, but not in men, is related to worse cognitive function.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 1","pages":"Article 100102"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Clinical Efficacy of Elexacaftor-Tezacaftor-Ivacaftor in People With Cystic Fibrosis and Preexisting Advanced Lung Disease at Treatment Initiation","authors":"Leah A. Cohen MD ,&nbsp;Gregory A. Ratti MD ,&nbsp;April R. Gorman MS ,&nbsp;Bryan Garcia MD ,&nbsp;Christina M. Mingora MD","doi":"10.1016/j.chpulm.2024.100099","DOIUrl":"10.1016/j.chpulm.2024.100099","url":null,"abstract":"<div><h3>Background</h3><div>Elexacaftor-tezacaftor-ivacaftor (ETI) is associated with increased FEV₁, decreased exacerbation frequency, and BMI in people with cystic fibrosis. Landmark clinical trials excluded patients with advanced lung disease as defined by FEV₁ &lt; 40%. We have previously reported an improvement in % predicted FEV₁ of 7.9% after 3 months of ETI in people with advanced cystic fibrosis lung disease (ACFLD). The long-term effects of ETI on this cohort are unknown. This study reports the efficacy of ETI after 24 months of treatment in people with ACFLD.</div></div><div><h3>Research Question</h3><div>What are the long-term effects of ETI on people with cystic fibrosis and pre-existing advanced lung disease on lung function, BMI, and pulmonary exacerbation rates?</div></div><div><h3>Study Design and Methods</h3><div>We conducted a retrospective cohort study of adult patients with FEV₁ &lt; 40% and/or other high-risk features defined by the 2019 Cystic Fibrosis Foundation lung transplant guidelines who were started on ETI between September 2019 and February 2020. Response to therapy was assessed with repeat spirometry measured at 12 and 24 months. All measurements were taken outside of an acute exacerbation. Demographics and clinical data including BMI and pulmonary exacerbation frequency were extracted from the medical record.</div></div><div><h3>Results</h3><div>A total of 57 of 64 people with ACFLD showed improved lung function with a mean change in % predicted FEV₁ of 6.74% (<em>P</em> ≤ .001; 95% CI, 4.25%-9.23%) between baseline and 24 months of treatment. BMI increased by a mean change of 1.55 kg/m² (<em>P</em> ≤ .001; 95% CI, 0.93-2.18 kg/m²) during this interval. The annual exacerbation rate between the year before ETI and 24 months on ETI declined with a median of 1 less per year (<em>P</em> = .0007).</div></div><div><h3>Interpretation</h3><div>People with ACFLD experienced a significant increase in lung function at 24 months on ETI, but less than those with higher baseline lung function compared with prior studies. They also had an increase in BMI and a decline in the rate of annual pulmonary exacerbations.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 1","pages":"Article 100099"},"PeriodicalIF":0.0,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143452755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dyspnea in a Patient With Metastatic Breast Cancer","authors":"","doi":"10.1016/j.chpulm.2024.100074","DOIUrl":"10.1016/j.chpulm.2024.100074","url":null,"abstract":"<div><h3>Case Presentation</h3><p>A 76-year-old female with a history of estrogen receptor-positive/progesterone receptor-positive/HER2-negative breast cancer presented to the pulmonary clinic with severe exertional dyspnea. She had no known history of cardiopulmonary disease and was in her usual state of health until 3 months prior to her presentation when she was diagnosed with a breast cancer recurrence in an axillary lymph node with associated osseous metastases. Subsequently, she had developed rapidly progressive exercise intolerance, orthopnea, and lower extremity edema.</p></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 3","pages":"Article 100074"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789224000400/pdfft?md5=8d86ff6674243e6331b7d8532856a85f&pid=1-s2.0-S2949789224000400-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141394144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rebuttal From Dr Kim et al","authors":"","doi":"10.1016/j.chpulm.2024.100069","DOIUrl":"10.1016/j.chpulm.2024.100069","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 3","pages":"Article 100069"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789224000357/pdfft?md5=559ef83bde3a7c5f851a39ffd03fa2c1&pid=1-s2.0-S2949789224000357-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141392961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rebuttal From Dr Nadig et al","authors":"","doi":"10.1016/j.chpulm.2024.100068","DOIUrl":"10.1016/j.chpulm.2024.100068","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 3","pages":"Article 100068"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789224000345/pdfft?md5=2bc971119d8bd1dbbca2e46885feec49&pid=1-s2.0-S2949789224000345-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141406179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Male Sex With Worse Right Ventricular Function and Survival in Pulmonary Hypertension in the Redefining Pulmonary Hypertension Through Pulmonary Vascular Disease Phenomics Cohort","authors":"","doi":"10.1016/j.chpulm.2024.100046","DOIUrl":"10.1016/j.chpulm.2024.100046","url":null,"abstract":"<div><h3>Background</h3><p>Sex-based differences are important in the development and progression of pulmonary arterial hypertension. However, it is not established whether these differences are generalizable to all forms of pulmonary hypertension (PH).</p></div><div><h3>Research Question</h3><p>What are the sex-based differences in right ventricle (RV) function and transplant-free survival in patients with PH from the Redefining Pulmonary Hypertension Through Pulmonary Vascular Disease Phenomics (PVDOMICS) cohort?</p></div><div><h3>Study Design and Methods</h3><p>Patients with PH enrolled in the PVDOMICS cohort study underwent right heart catheterization, cardiac MRI, and echocardiography. A multivariable linear regression model was used to investigate the interactive effect between sex and pulmonary vascular resistance (PVR) on RV ejection fraction (RVEF). Effects of sex, RVEF, and PVR on transplant-free survival were assessed using a Cox proportional hazards model.</p></div><div><h3>Results</h3><p>Seven hundred fifty patients with PH (62.8% female) were enrolled, including 397 patients with groups 2 through 5 PH. Patients with group 1 PH were predominantly female (73.4%). Male patients showed multiple markers of worse RV function with significantly lower RVEF (adjusted difference, 5.5%; 95% CI, 3.2%-7.8%; <em>P &lt;</em> .001) on cardiac MRI and lower RV fractional shortening (adjusted difference, 4.0%; 95% CI, 2.3%-5.8%; <em>P &lt;</em> .001) and worse RV free-wall longitudinal strain (adjusted difference, 2.4%; 95% CI, 1.2%-3.6%; <em>P &lt;</em> .001) on echocardiography. Significant interaction was noted between PVR and sex on RVEF, with the largest sex-based differences in RVEF noted at mild to moderate PVR elevation. Male sex was associated with decreased transplant-free survival (adjusted hazard ratio, 1.46; 95% CI, 1.07-1.98; <em>P =</em> .02), partially mediated by differences in RVEF (<em>P =</em> .003).</p></div><div><h3>Interpretation</h3><p>In patients with PH in the PVDOMICS study, female sex was more common, whereas male sex was associated with worse RV function and decreased transplant-free survival, most notably at mild to moderate elevation of PVR.</p></div><div><h3>Trial Registry</h3><p><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>; No.: <span><span>NCT02980887</span><svg><path></path></svg></span>; URL: <span><span>www.clinicaltrials.gov</span><svg><path></path></svg></span></p></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 3","pages":"Article 100046"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789224000126/pdfft?md5=621a5785c04264fd9403c74859455b8d&pid=1-s2.0-S2949789224000126-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140269592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Upper Limit of Normal Rate of Lung Function Decline in Healthy Adults in the Framingham Heart Study","authors":"","doi":"10.1016/j.chpulm.2024.100058","DOIUrl":"10.1016/j.chpulm.2024.100058","url":null,"abstract":"<div><h3>Background</h3><p>Lung function declines over the course of adulthood; however, a consensus on the normal range of decline in an individual’s lung function is lacking.</p></div><div><h3>Research Question</h3><p>What is the normal range and the upper limit of normal (ULN) decline in lung function in adults without prior tobacco use, occupational dust exposure, or a known diagnosis or symptoms of cardiopulmonary disease?</p></div><div><h3>Study Design and Methods</h3><p>A retrospective analysis of healthy individuals who have never smoked (N = 1,305) from the Framingham Heart Study with repeated lung function meeting standards for acceptability and reproducibility was conducted. Longitudinal change was derived using a linear mixed effects model and estimated to a 6-year interval. The ULN decline was defined as the 95th percentile.</p></div><div><h3>Results</h3><p>The mean follow-up between spirometry examinations was 5.5 years, whereas the mean follow-up between diffusing capacity for carbon monoxide studies was 5.9 years. Decline in FEV₁, FVC, and D accelerated with age, whereas decline in FEV₁/FVC decelerated with age. Decline varied with sex, age, and height. Over a 6-year period, the ULN decline in FEV₁ ranged from 383 to 667 mL, and the ULN decline in D<span>lco</span> ranged from 3.6 to 9.5 mL/min/mm Hg. Overall, male individuals had faster absolute rates of decline than female individuals, whereas relative (%) rates of decline were similar between sexes.</p></div><div><h3>Interpretation</h3><p>Lung function decline is nonlinear and accelerates with age. In this cohort, the ULN decline over 6 years often exceeded current guidelines for interpreting significant longitudinal change in lung function.</p></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 3","pages":"Article 100058"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789224000242/pdfft?md5=56df745686b5a15555aef18bf84cad8f&pid=1-s2.0-S2949789224000242-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140794374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}