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Idiopathic pulmonary fibrosis mortality: update on trends in the modern treatment era Eur. Respir. J. (IF 16.6) Pub Date : 2024-08-22 Anna J. Podolanczuk, Ganesh Raghu
Extract Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease caused by a combination of genetic and environmental factors [1]. Studies indicate that the global incidence and prevalence of IPF are increasing [2–8]. The reasons for this are not fully understood, but contributors include more widespread use of computed tomography (CT) imaging, improved recognition of the disease, an ageing
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Stepping down biologics in asthma: is it time to challenge the status quo? Eur. Respir. J. (IF 16.6) Pub Date : 2024-08-22 Sandhya Khurana, Steve N. Georas
Extract Rapid advances in biologic therapy have truly revolutionised the management of severe asthma in the past decade. The efficacy of these drugs has been undeniably demonstrated in randomised controlled trials (RCTs) and real-world studies, with reassuring safety data. Many patients with severe asthma have had their lives transformed after starting a biologic, which is an extremely gratifying result
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Titration of anti-IL-5 biologics in severe asthma: an open-label randomised controlled trial (the OPTIMAL study) Eur. Respir. J. (IF 16.6) Pub Date : 2024-08-22 Marianne Baastrup Soendergaard, Anne-Sofie Bjerrum, Linda Makowska Rasmussen, Sofie Lock-Johansson, Ole Hilberg, Susanne Hansen, Anna von Bulow, Celeste Porsbjerg
Extract The treatment of severe eosinophilic asthma has been revolutionised with the introduction of anti-interleukin (IL)-5 biological treatment. Anti-IL-5 biologics include mepolizumab, benralizumab and reslizumab, all of which target the IL-5 pathway; regulatory randomised controlled trials (RCTs) have shown that they are efficient in reducing exacerbation rates and the need for maintenance oral
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Mortality trends in idiopathic pulmonary fibrosis in Europe between 2013 and 2018 Eur. Respir. J. (IF 16.6) Pub Date : 2024-08-22 Francesca Gonnelli, Martina Bonifazi, Richard Hubbard
Extract Previous studies in the UK [1] and Europe [2] have shown that the mortality from idiopathic pulmonary fibrosis (IPF) has increased over time, but up-to-date studies using consistent methodology are limited. The last reliable European estimate of IPF mortality was provided by Marshall et al. [2] using World Health Organization (WHO) data. Their study showed that the mortality rate from IPF increased
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The end of the road for blood RNA biomarkers as triage tests for symptomatic pulmonary tuberculosis among spontaneous sputum producers? Eur. Respir. J. (IF 16.6) Pub Date : 2024-08-15 James Greenan-Barrett, Rishi K. Gupta, Mahdad Noursadeghi
Extract In 2022, an estimated 3.1 million people with tuberculosis (TB) remained undiagnosed [1] despite the global roll-out of rapid molecular tests for Mycobacterium tuberculosis, such as Xpert Ultra and Truenat MTB plus [2]. In pulmonary TB, these tests rely on the availability of a respiratory sample. Sputum induction or invasive sampling are required in sputum-scarce individuals, but often unavailable
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Lunging through the pollution–exercise paradox: clean air during Olympic and Paralympic Games and beyond Eur. Respir. J. (IF 16.6) Pub Date : 2024-08-15 Christopher Carlsten, Isabella Annesi-Maesano
Extract The 2024 Olympic Games and Paralympic Games lead us, as pulmonologists, to reflect on the sport, air pollution and respiratory health triad, and potential compromises at their intersection. Prompted by the scrutiny for any factor that can tip the highly competitive scale of the Games, this theme is of interest to all citizens well beyond the spotlight and glory of these dramatic events.
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The importance of airway IL-1β in patients with bronchiectasis Eur. Respir. J. (IF 16.6) Pub Date : 2024-08-15 Jeremy S. Brown
Extract Airway inflammation drives both the development of bronchiectasis and results in the dominant clinical features. Many aetiologies of bronchiectasis, including previous infection, COPD, rheumatoid arthritis, allergic bronchopulmonary aspergillosis and toxic exposures, cause airway inflammation that damages the bronchial wall, which then allows chronic infection to be established. When bronchiectasis
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Pulmonary arterial wedge pressure in healthy subjects: a meta-analysis Eur. Respir. J. (IF 16.6) Pub Date : 2024-08-15 Katarina Zeder, Alexander Avian, Susanna Mak, George Giannakoulas, Steven M. Kawut, Bradley A. Maron, Marc Humbert, Horst Olschewski, Gabor Kovacs
Extract Based on current international guidelines, pulmonary arterial wedge pressure (PAWP) is critical for differentiating between pre- and post-capillary pulmonary hypertension (PH) and plays an important role in the diagnosis of left heart failure [1, 2]. The current PAWP threshold to define post-capillary PH is >15 mmHg, measured by right heart catheterisation (RHC) in the supine position [1].
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Blood transcriptomic signatures for symptomatic tuberculosis in an African multicohort study Eur. Respir. J. (IF 16.6) Pub Date : 2024-08-15 Vanessa Mwebaza Muwanga, Simon C. Mendelsohn, Vinzeigh Leukes, Kim Stanley, Stanley Kimbung Mbandi, Mzwandile Erasmus, Marika Flinn, Tarryn-Lee Fisher, Rodney Raphela, Nicole Bilek, Stephanus T. Malherbe, Gerard Tromp, Gian Van Der Spuy, Gerhard Walzl, Novel N. Chegou, Thomas J. Scriba
Background Multiple host blood transcriptional signatures have been developed as non-sputum triage tests for tuberculosis (TB). We aimed to compare the diagnostic performance of 20 blood transcriptomic TB signatures for differentiating between symptomatic patients who have TB versus other respiratory diseases (ORD). Methods As part of a nested case–control study, individuals presenting with respiratory
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ERS statement on transition of care in childhood interstitial lung diseases Eur. Respir. J. (IF 16.6) Pub Date : 2024-08-15 Petr Pohunek, Effrosyni Manali, Susanne Vijverberg, Julia Carlens, Felix Chua, Ralph Epaud, Carlee Gilbert, Matthias Griese, Bulent Karadag, Eitan Kerem, Václav Koucký, Nadia Nathan, Spyridon Papiris, Suzanne Terheggen-Lagro, Lukáš Plch, Alba Torrent Vernetta, Andrew Bush
Interstitial lung diseases (ILD) are a heterogeneous group of rare diffuse diseases affecting the lung parenchyma in children and adults. Childhood interstitial lung diseases (chILD) are often diagnosed at very young age, affect the developing lung, and can have different presentations and prognosis compared to adult forms of these diseases. In addition, chILD in many cases may apparently remit, and
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Airway IL-1β is related to disease severity and mucociliary function in bronchiectasis Eur. Respir. J. (IF 16.6) Pub Date : 2024-08-15 Lidia Perea, Mathieu Bottier, Erin Cant, Hollian Richardson, Alison J. Dicker, Morven Shuttleworth, Yan Hui Giam, Hani Abo-Leyah, Simon Finch, Jeffrey T-J. Huang, Michal Shteinberg, Pieter C. Goeminne, Eva Polverino, Josje Altenburg, Francesco Blasi, Tobias Welte, Stefano Aliberti, Oriol Sibila, James D. Chalmers, Amelia Shoemark
Rationale The inflammasome is a key regulatory complex of the inflammatory response leading to interleukin-1β (IL-1β) release and activation. IL-1β amplifies inflammatory responses and induces mucus secretion and hyperconcentration in other diseases. The role of IL-1β in bronchiectasis has not been investigated. Objectives To characterise the role of airway IL-1β in bronchiectasis, including the association
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Advances in non-type 2 severe asthma: from molecular insights to novel treatment strategies Eur. Respir. J. (IF 16.6) Pub Date : 2024-08-15 Tao Liu, Prescott G. Woodruff, Xiaobo Zhou
Asthma is a prevalent pulmonary disease that affects more than 300 million people worldwide and imposes a substantial economic burden. While medication can effectively control symptoms in some patients, severe asthma attacks, driven by airway inflammation induced by environmental and infectious exposures, continue to be a major cause of asthma-related mortality. Heterogeneous phenotypes of asthma include
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The burden of zoster in asthma: what is left to learn? Eur. Respir. J. (IF 16.6) Pub Date : 2024-08-08 Chloe Bloom
Extract Herpes zoster (HZ) is caused by the reactivation of latent varicella zoster virus and typically manifests as painful erythematous vesicles erupted along a single dermatome. The pain is often excruciating, occurring alongside constitutional symptoms such as headache, fever and malaise. It is fortunately, usually, self-limiting to around 2–3 weeks, but up to 10% suffer with debilitating, postherpetic
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Not all are the same: the power of registries in defining genotype–phenotype relationships in primary ciliary dyskinesia Eur. Respir. J. (IF 16.6) Pub Date : 2024-08-08 Amjad Horani, Pleasantine Mill
Extract Steve Jobs once said "You can't connect the dots looking forward; you can only connect them looking backwards. So you have to trust that the dots will somehow connect in your future." This holds especially true when dealing with rare conditions. Patterns often only emerge when you step back from individual patients and clinics and look over large multicentre datasets. Clinical registries are
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Global herpes zoster burden in adults with asthma: a systematic review and meta-analysis Eur. Respir. J. (IF 16.6) Pub Date : 2024-08-08 Kevin J. Mortimer, Alvaro A. Cruz, Ingrid T. Sepúlveda-Pachón, Anamaria Jorga, Hilde Vroling, Charles Williams
Background Asthma is a common respiratory disease, which may be associated with an increased risk of herpes zoster (HZ), often a debilitating disease associated with severe pain. This is the first systematic review with the objective of summarising evidence on HZ burden in adults with asthma. Methods A global systematic literature review and meta-analysis was conducted (MEDLINE and Embase, 2003–2024)
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Telerehabilitation: a key player in reducing the travel emissions cost of respiratory healthcare? Eur. Respir. J. (IF 16.6) Pub Date : 2024-08-08 Melissa Chong, Anne E. Holland, Angela T. Burge, Jaycie Perryman, Narelle S. Cox
Extract Climate change from rising concentrations of greenhouse gas emissions is a critical global public health concern [1]. The healthcare sector is a major contributor to greenhouse emissions with the USA, China and the European Union generating more than half the global healthcare climate emissions annually [2]. Healthcare sector carbon emissions are predominantly created by infrastructure cost
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Surgically resectable nonsmall cell lung cancer: a contemporary approach Eur. Respir. J. (IF 16.6) Pub Date : 2024-08-08 Marie-Frédérique D'Amours, Florence T.H. Wu, Olivia Theisen-Lauk, Elisa K. Chan, Anna McGuire, Cheryl Ho
New treatment paradigms for resectable nonsmall cell lung cancer (NSCLC), with an emphasis on personalised care and a multidisciplinary approach, have significantly improved patient outcomes. The incorporation of immune checkpoint inhibitors into neoadjuvant, perioperative and adjuvant treatment algorithms is reshaping the standard of care for resectable NSCLC. Adjuvant targeted therapy trials have
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Long-term effect of obstructive sleep apnoea management on blood pressure in patients with resistant hypertension: the SARAH study Eur. Respir. J. (IF 16.6) Pub Date : 2024-08-08 Gerard Torres, Manuel Sánchez-de-la-Torre, Esther Gracia-Lavedan, Ivan D. Benitez, Dolores Martinez, Mireia Dalmases, Lucía Pinilla, Olga Minguez, Rafaela Vaca, Lydia Pascual, Maria Aguilá, Anunciación Cortijo, Clara Gort, Miguel Ángel Martinez-Garcia, Olga Mediano, Sofía Romero Peralta, Ana Maria Fortuna-Gutierrez, Paola Ponte Marquez, Luciano F. Drager, Mayara Cabrini, Silvana de Barros, Juan Fernando
Background There is a close relationship between obstructive sleep apnoea (OSA) and resistant hypertension (RH). However, studies assessing the long-term effect of diagnosing and treating OSA on blood pressure (BP) control in these patients are lacking. Methods To address this gap, we recruited 478 RH patients from hypertension units and followed them prospectively after they were screened for OSA
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Missing airways, ventilation defects and conductive airway physiology in asthma Eur. Respir. J. (IF 16.6) Pub Date : 2024-08-08 Sylvia Verbanck, Rachel L. Eddy, Marrissa J. McIntosh, Grace Parraga, Brody H. Foy
Extract While airway obstruction, either by excessive luminal narrowing or mucus plugs, is recognised as a characteristic feature of various lung diseases, its measurement by physiological testing or lung imaging has been challenging. Currently, combined application of multiple imaging modalities allows for the quantification of obstructed airways and their link to ventilation defects. In asthma, computed
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The 2022 ERS/ATS z-score classification to grade airflow obstruction: relationship with exercise outcomes across the spectrum of COPD severity Eur. Respir. J. (IF 16.6) Pub Date : 2024-08-08 Lamyaa Al Sa'idi, Danilo C. Berton, J. Alberto Neder
Extract Spirometry remains pivotal to the diagnosis and classification of functional impairment in patients with COPD [1]. A growing emphasis has been placed on using the z-score to grade dysfunction, as it appropriately considers the age- and height-related variability in forced expiratory volume in 1 s (FEV1) within comparable, healthy individuals [2].
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Analyses of 1236 genotyped primary ciliary dyskinesia individuals identify regional clusters of distinct DNA variants and significant genotype–phenotype correlations Eur. Respir. J. (IF 16.6) Pub Date : 2024-08-08 Johanna Raidt, Sarah Riepenhausen, Petra Pennekamp, Heike Olbrich, Israel Amirav, Rodrigo A. Athanazio, Micha Aviram, Juan E. Balinotti, Ophir Bar-On, Sebastian F.N. Bode, Mieke Boon, Melissa Borrelli, Siobhan B. Carr, Suzanne Crowley, Eleonora Dehlink, Sandra Diepenhorst, Peter Durdik, Bernd Dworniczak, Nagehan Emiralioğlu, Ela Erdem, Rossella Fonnesu, Serena Gracci, Jörg Große-Onnebrink, Karolina
Background Primary ciliary dyskinesia (PCD) represents a group of rare hereditary disorders characterised by deficient ciliary airway clearance that can be associated with laterality defects. We aimed to describe the underlying gene defects, geographical differences in genotypes and their relationship to diagnostic findings and clinical phenotypes. Methods Genetic variants and clinical findings (age
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ERJ Podcast July 2024: Smoking and vaping alter genes related to SARS-CoV-2 infection Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-31 European Respiratory Society
As part of the July issue, the European Respiratory Journal presents the latest in its series of podcasts. Chief Editor James Chalmers interviews Rachel Bowsher (Toxicology Department, UK Health Security Agency, Chilton, and Pharmacology Section, St George’s University of London, London, UK) about a study that uses novel methodology to demonstrate that smoking and vaping alter genes related to mechanisms
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Low smoking exposure and development and prognosis of COPD over four decades: A population-based cohort study. Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-26 Yunus Çolak,Anders Løkke,Jacob L Marott,Peter Lange,Jørgen Vestbo,Børge G Nordestgaard,Shoaib Afzal
A diagnosis of chronic obstructive pulmonary disease (COPD) is mainly considered in individuals with more than 10 pack-years of smoking. We tested the hypothesis that low smoking exposure, below the critical threshold of 10 pack-years, increases risk of COPD and leads to poor prognosis.We followed non-obstructive adult smokers from the Copenhagen City Heart Study for COPD, defined as forced expiratory
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Optimisation of detecting chronic thromboembolic pulmonary hypertension in acute pulmonary embolism survivors: the InShape IV study. Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-26 Dieuwke Luijten,Luca Valerio,Gudula J A M Boon,Stefano Barco,Harm Jan Bogaard,Marion Delcroix,Yvonne Ende-Verhaar,Menno V Huisman,Luis Jara-Palomares,Karl-Friedrich Kreitner,Lucia J M Kroft,Albert Ta Mairuhu,Anna C Mavromanoli,Lilian J Meijboom,Thijs E van Mens,Maarten K Ninaber,Esther J Nossent,Piotr Pruszczyk,Stephan Rosenkranz,Hubert Vliegen,Anton Vonk Noordegraaf,Stavros V Konstantinides,Frederikus
INTRODUCTION Chronic thromboembolic pulmonary hypertension (CTEPH) is often diagnosed late in acute pulmonary embolism (PE) survivors: more efficient testing to expedite diagnosis may considerably improve patient outcomes. The InShape II algorithm safely rules out CTEPH (failure rate 0.29%) while requiring echocardiography in only 19% of patients but may be improved by adding detailed reading of the
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Epigenomic partitioning of a polygenic risk score for asthma reveals distinct genetically driven disease pathways. Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-26 Bernard Stikker,Lianne Trap,Bahar Sedaghati-Khayat,Marjolein J W de Bruijn,Wilfred F J van Ijcken,Emmely de Roos,Arfan Ikram,R W Hendriks,Guy Brusselle,Jeroen van Rooij,Ralph Stadhouders
BACKGROUND Individual differences in susceptibility to develop asthma, a heterogeneous chronic inflammatory lung disease, are poorly understood. It remains debated whether genetics can predict asthma risk and how genetic variants modulate the complex pathophysiology of asthma. AIM To build polygenic risk scores (PRSs) for asthma risk prediction and epigenomically link predictive genetic variants to
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Genetic predisposition to high BMI increases risk of early life respiratory infections and episodes of severe wheeze and asthma. Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-26 Signe Kjeldgaard Jensen,Casper-Emil Tingskov Pedersen,Kasper Fischer-Rasmussen,Mathias Elsner Melgaard,Nicklas Brustad,Julie Nyholm Kyvsgaard,Nilo Vahman,Ann-Marie Malby Schoos,Jakob Stokholm,Bo Chawes,Anders Eliasen,Klaus Bønnelykke
BACKGROUND High BMI is an established risk factor for asthma, but the underlying mechanisms remain unclear.Objective: To increase understanding of the BMI-asthma relationship by studying the association between genetic predisposition to higher body mass index (BMI) and asthma, infections, and other asthma-traits during childhood. METHODS Data was obtained from the two ongoing COPSAC mother-child cohorts
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Electronically delivered rehabilitation after acute pulmonary embolism is safe and improves quality of life. Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-26 Daniel Lachant,Deborah Haight,Dominick Roto,Alyssa Williams,Kyle Norton,R James White
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Risk stratification refinements with inclusion of haemodynamic variables at follow-up in patients with pulmonary arterial hypertension. Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-26 Athénaïs Boucly,Antoine Beurnier,Ségolène Turquier,Mitja Jevnikar,Pascal de Groote,Ari Chaouat,Céline Cheron,Xavier Jaïs,François Picard,Grégoire Prévot,Anne Roche,Sabina Solinas,Vincent Cottin,Fabrice Bauer,David Montani,Marc Humbert,Laurent Savale,Olivier Sitbon,
BACKGROUND AND AIMS Haemodynamic variables are prognostic factors in pulmonary arterial hypertension (PAH). However, right heart catheterization (RHC) is not systematically recommended to assess the risk-status during follow-up. This study aimed to assess the added value of haemodynamic variables in prevalent patients to predict the risk of death or lung transplantation according to their risk status
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A Proposed Approach to Pulmonary Long COVID: A Viewpoint. Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-26 Firoozeh V Gerayeli,Rachel Eddy,Don D Sin
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Artificial intelligence meets pulmonary hypertension: early detection for a late-presenting disease Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-25 Steven J. Cassady, Bradley A. Maron
Extract Pulmonary hypertension (PH) is a complex disease associated with a seven-fold increase in 1-year mortality compared to the general population [1]. Standardising the approach to diagnosis and clinical evaluation is a long-standing priority in PH, with progress across these objectives likely to underlie rising disease incidence and prevalence [2]. However, PH diagnosis remains delayed, and may
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I love you with all my lungs: a viewpoint on communicating effectively and positively about lung health Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-25 Joan B. Soriano, Sara Lumbreras, Bartolomé R. Celli, Christine R. Jenkins
Extract The respiratory community is slowly but progressively learning effective communication strategies for promoting positive messages on lung health [1, 2]. Implementation research, or the systematic study of methods that support the application of research findings and other evidence-based knowledge into policy and practice [3], has been mostly used in communicable, infectious diseases, as exemplified
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Video-based direct observation physiotherapy in children with cystic fibrosis: a randomised controlled trial Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-25 Sheetal Agarwal, Kana Ram Jat, Sumita Gupta, Jhuma Sankar, Rakesh Lodha, S.K. Kabra
Extract Airway clearance therapy (ACT) is integral to management of cystic fibrosis (CF) [1]. Adherence to therapy in patients with CF is generally poor for inhaled medications and ACT as they are time-consuming [2]. The reported adherence rate to ACT ranges from 33% to 91%, and the variation may be due to differences in the parameters used to assess ACT [3]. However, the "adherence rate with the correct
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Mendelian randomisation supports no evidence of the association between asthma and coronary heart disease in East Asians Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-25 Jiawen Lu, Zhenqian Wang
Extract We were very interested to read the recent paper by Valencia-Hernández et al. [1], who conducted a prospective study of 1 522 910 UK individuals and a Mendelian randomisation (MR) study. They discovered that asthma was not a risk factor for coronary heart disease (CHD) among European individuals [1]. Nevertheless, their finding was restricted to European individuals and may not be generalisable
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An electrocardiogram-based AI algorithm for early detection of pulmonary hypertension Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-25 Hilary M. DuBrock, Tyler E. Wagner, Katherine Carlson, Corinne L. Carpenter, Samir Awasthi, Zachi I. Attia, Robert P. Frantz, Paul A. Friedman, Suraj Kapa, Jeffrey Annis, Evan L. Brittain, Anna R. Hemnes, Samuel J. Asirvatham, Melwin Babu, Ashim Prasad, Unice Yoo, Rakesh Barve, Mona Selej, Peter Agron, Emily Kogan, Deborah Quinn, Preston Dunnmon, Najat Khan, Venky Soundararajan
Background Early diagnosis of pulmonary hypertension (PH) is critical for effective treatment and management. We aimed to develop and externally validate an artificial intelligence algorithm that could serve as a PH screening tool, based on analysis of a standard 12-lead ECG. Methods The PH Early Detection Algorithm (PH-EDA) is a convolutional neural network developed using retrospective ECG voltage–time
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Smoking and vaping alter genes related to mechanisms of SARS-CoV-2 susceptibility and severity: a systematic review and meta-analysis Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-25 Rachel Bowsher, Timothy H. Marczylo, Karen Gooch, Alexis Bailey, Matthew D. Wright, Emma L. Marczylo
Background Evidence for the impact of smoking on coronavirus disease 2019 (COVID-19) is contradictory, and there is little research on vaping. Here we provide greater clarity on mechanisms perturbed by tobacco cigarette, electronic cigarette and nicotine exposures that may impact the risks of infection and/or disease severity. Methods Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses
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“Airway clearance management in people with bronchiectasis: data from the European Bronchiectasis Registry (EMBARC).” A. Spinou, B. Hererro-Cortina, S. Aliberti, et al. Eur Respir J 2024; 63: 2301689. Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-25 European Respiratory Society
This article was originally published with one of the author’s names …
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Caregiver burden due to long-term breathlessness: a hypothesis-generating study Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-25 Slavica Kochovska, Diana Ferreira, Sungwon Chang, Tim Luckett, Jessica Roydhouse, Magnus Ekström, David C. Currow
Extract Long-term breathlessness is a debilitating symptom that affects people's quality of life [1]. When it limits everyday activities [2], social isolation and greater physical dependence on others can also occur [3]. Caregivers (i.e. family/friends who provide care/support to people with long-term breathlessness) experience significant burden due to their caregiving role. Living in a constant state
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Diagnostic delay and access to care in bronchiectasis: data from the EMBARC/ELF patient survey Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-25 Arietta Spinou, Marta Almagro, Bridget Harris, Jeanette Boyd, Tove Berg, Beatriz Herrero-Cortina, Annette Posthumous, Stefano Aliberti, Barbara Crossley, Thomas F. Ruddy, Nili Stein, Megan L. Crichton, Pieter C. Goeminne, James D. Chalmers, Michal Shteinberg
Extract Bronchiectasis is receiving increased awareness from clinicians, researchers and stakeholders. However, despite the development of international and national guidelines in bronchiectasis, clinical practice does not necessarily follow quality standards and clinical recommendations. The European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) together with the European Lung
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An exercise in relaxation: right ventricular diastolic function predicts exercise capacity in pulmonary arterial hypertension Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-18 Michael T. Patterson, Kurt W. Prins
Extract Right ventricular (RV) dysfunction is a well-recognised contributor to exercise intolerance and poor long-term outcomes in pulmonary arterial hypertension (PAH) [1]; however, detailed evaluations of the RV's response to exercise in PAH are only beginning to be conducted [2]. Furthermore, there are both systolic and diastolic impairments in the pressure-overloaded right ventricle [3], but the
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Murder, she wrote: a long story on long COVID is being written Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-18 Joan B. Soriano, Julio Ancochea
Extract In the TV series Murder, She Wrote, from 1984 and for more than a decade, a mystery writer and amateur detective, portrayed by Angela Lansbury (1925–2022), was involved in solving murders taking place across the USA and abroad (figure 1). We are doomed to learning to live with COVID-19 and long COVID, and while many findings and information are already available, many more mysteries are yet
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Automating detection of inspiratory flow limitation: the next frontier in assessing sleep disordered breathing in pregnancy and risk for adverse pregnancy outcomes? Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-18 Sushmita Pamidi, Indu Ayappa
Extract Sleep disordered breathing (SDB) during pregnancy has been associated with various adverse pregnancy outcomes and is increasingly gaining recognition as a significant yet often overlooked aspect of maternal health. Notably, accumulating evidence from prospective cohort and clinical studies has shown robust associations between SDB during pregnancy and hypertensive disorders of pregnancy, pre-eclampsia
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Poor cardiac output reserve in pulmonary arterial hypertension is associated with right ventricular stiffness and impaired interventricular dependence Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-18 Ilton M. Cubero Salazar, Andrew C. Lancaster, Vivek P. Jani, Margaret J. Montovano, Matthew Kauffman, Alexandra Weller, Bharath Ambale-Venkatesh, Stefan L. Zimmerman, Catherine E. Simpson, Todd M. Kolb, Rachel L. Damico, Stephen C. Mathai, Monica Mukherjee, Ryan J. Tedford, Paul M. Hassoun, Steven Hsu
Extract Pulmonary arterial hypertension (PAH) is characterised by adverse pulmonary vascular remodelling that results in a progressive pathological elevation of pulmonary pressures, right ventricular (RV) failure, worsening exertional limitation and premature death [1]. Declines in exercise capacity signal disease progression and portend poor prognosis [2–5]. Appropriately, exercise capacity and the
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Symptoms before and after COVID-19: a population and case–control study using prospective data Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-18 Carole H. Sudre, Michela Antonelli, Nathan J. Cheetham, Erika Molteni, Liane S. Canas, Vicky Bowyer, Ben Murray, Khaled Rjoob, Marc Modat, Joan Capdevila Pujol, Christina Hu, Jonathan Wolf, Tim D. Spector, Alexander Hammers, Claire J. Steves, Sebastien Ourselin, Emma L. Duncan
Background Some individuals experience prolonged illness after acute coronavirus disease 2019 (COVID-19). We assessed whether pre-infection symptoms affected post-acute COVID illness duration. Methods Survival analysis was performed in adults (n=23 452) with community-managed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection prospectively self-logging data through the ZOE COVID
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Adverse pregnancy outcomes and pharyngeal flow limitation during sleep: Nulliparous Pregnancy Outcomes Study Monitoring Mothers-to-be (nuMoM2b) Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-18 Raichel M. Alex, Dwayne L. Mann, Ali Azarbarzin, Daniel Vena, Laura K. Gell, Andrew Wellman, William A. Grobman, Francesca L. Facco, Robert M. Silver, Grace W. Pien, Judette M. Louis, Phyllis C. Zee, Michael Rueschman, Tamar Sofer, Susan Redline, Scott A. Sands
Background Pharyngeal flow limitation during pregnancy may be a risk factor for adverse pregnancy outcomes but was previously challenging to quantify. Our objective was to determine whether a novel objective measure of flow limitation identifies an increased risk of pre-eclampsia (primary outcome) and other adverse outcomes in a prospective cohort: Nulliparous Pregnancy Outcomes Study Monitoring Mothers-to-be
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Long-term radiological and pulmonary function abnormalities at 3 years after COVID-19 hospitalisation: a longitudinal cohort study Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-18 Xiaoyu Han, Lu Chen, Liyan Guo, Linxia Wu, Osamah Alwalid, Jie Liu, Yuting Zheng, Leqing Chen, Wenlong Wu, Hanting Li, Qinyue Luo, Huangxuan Zhao, Lijie Zhang, Yaowei Bai, Bo Sun, Tao Sun, Yuxi Gui, Tong Nie, Lei Chen, Fan Yang, Yanqing Fan, Heshui Shi, Chuansheng Zheng
Extract On 3 May 2023, the World Health Organization (WHO) released the coronavirus disease 2019 (COVID-19) strategic preparedness and response plan for 2023–2025 that emphasises the significance of establishing an evidence base regarding the post-COVID condition [1, 2]. Emerging data show that ~50% of COVID-19 survivors experience long-term respiratory sequelae, such as chronic dyspnoea, cough and
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The casting of invasive cardiopulmonary exercise testing: towards a common goal Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-11 Inderjit Singh, Aaron B. Waxman
Extract In the 1920s, on the backdrop of explosive industrial growth, the Harvard Fatigue Laboratory (1924–1947) performed extensive physiological and chemical studies in exercising individuals that helped shape our understanding of exercise physiology today [1]. Although its initial construct was designed to study the physiology of fatigue in the workplace [2], the innovative experimental techniques
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Reply to: Opioids for dyspnoea in interstitial lung disease: does the sequence and timing of therapy matter? Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-11 Diana H. Ferreira, Magnus Ekström, Sabrina Bajwah, Daisy J.A. Janssen, Belinda Fazekas, David C. Currow
Extract M. Kalluri and co-workers make several important points in considering the recently published double-blind, placebo-controlled, randomised crossover study of regular, low-dose, sustained-release morphine in people with interstitial lung disease (ILD) [1]. While our study was designed more than a decade ago, based on the best evidence at the time, it included people with physician-diagnosed
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Real world evidence in asthma: what to expect beyond randomised controlled trials? Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-11 Thibaud Soumagne, Bruno Degano
Extract Randomised controlled trials (RCTs) are regarded as the gold standard for assessing the efficacy and safety of treatments, and thus for guiding medical decisions. Although they are an essential element in clinical research, they do not always reflect the reality of clinical practice. Indeed, because of their rigorous methodology, their strict selection criteria and the fact that patients are
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High-quality and low-carbon asthma care go hand in hand Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-11 Alexander Wilkinson, Ashley Woodcock
Extract It is almost impossible to overstate the accelerating threats of the climate crisis to human health. In 2021, 127 million more people experienced food insecurity due to the climate crisis [1], 2022 saw a deadly summer heatwave that killed more than 60 000 people in Europe [2] and record wildfires in Canada in 2023 released greenhouse gases (GHGs) equivalent to 1.44 gigatonnes of CO2 and worsened
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Primary spontaneous pneumothorax: does size matter? Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-11 Gerben Keijzers, Michaela Donaghy, Mark Weatherall, Richard Beasley, Emma L. Ball, Graham Simpson, Diana Egerton-Warburton, Y.C. Gary Lee, Simon G.A. Brown
Extract There is increasing evidence supporting conservative management for patients with primary spontaneous pneumothorax (PSP), regardless of size [1, 2], which is reflected in the recent British Thoracic Society guidelines [3]. However, the size of the pneumothorax on the radiograph likely still has an important influence on management decisions, as illustrated by a recent interactive clinical decision
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A composite reference standard is needed for bedaquiline antimicrobial susceptibility testing for Mycobacterium tuberculosis complex Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-11 Claudio U. Köser, Paolo Miotto, Nabila Ismail, Richard M. Anthony, Christian Utpatel, Matthias Merker, Stefan Niemann, Sabira Tahseen, Leen Rigouts, Camilla Rodrigues, Shaheed V. Omar, Maha R. Farhat, Uladzimir Antonenka, Harald Hoffmann, Daniela M. Cirillo, Thomas Schön
Extract We echo the latest calls that have been made to increase the capacity for antimicrobial susceptibility testing (AST) for bedaquiline for the Mycobacterium tuberculosis complex [1, 2]. However, we would like to highlight the limitations of using insufficiently standardised or validated phenotypic AST methods and breakpoints as the reference standard for bedaquiline AST. Moreover, we advocate
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The effects of peripheral chemoreflex suppression on ventilatory efficiency and exercise duration in pulmonary arterial hypertension Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-11 Michael J. Plunkett, Ana Luiza C. Sayegh, Tanya J. McWilliams, Sasiharan Sithamparanathan, Julian F.R. Paton, James P. Fisher
Extract Exercise intolerance is debilitating for people with pulmonary arterial hypertension (PAH), limiting their ability to undertake work and exercise, and impeding daily personal care and household tasks [1]. Dyspnoea limits exercise capacity in PAH and may arise due to ventilatory inefficiency secondary to heightened peripheral chemoreflex sensitivity (i.e. excessive hypoxic ventilatory response)
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Right heart function during and after pregnancy in women with pulmonary arterial hypertension Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-11 Karen M. Olsson, Jan Fuge, Da-Hee Park, Jan C. Kamp, Dominik Berliner, Constantin von Kaisenberg, Marius M. Hoeper
Extract For many years, women diagnosed with pulmonary arterial hypertension (PAH) received advice against pregnancy due to a significant mortality risk [1, 2]. With therapeutic advancements, pregnancies in women with PAH continue to be associated with heightened risks, although uncomplicated pregnancies are increasingly being reported, particularly in women with well-controlled disease [3–6]. The
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Non-arterial line cardiac output calculation misclassifies exercise pulmonary hypertension and increases risk of data loss particularly in black, scleroderma and Raynaud's patients during invasive exercise testing Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-11 Luiz Campedelli, S. Mehdi Nouraie, Michael G. Risbano
Background The direct Fick principle is the standard for calculating cardiac output (CO) to detect CO-dependent conditions like exercise pulmonary hypertension (ePH). Fick COarterial incorporates arterial haemoglobin (Hba) and oxygen saturation (SaO2) with oxygen consumption from exercise testing, while Fick COnon-arterial substitutes mixed venous haemoglobin (Hbmv) and peripheral oxygen saturation
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Opioids for dyspnoea in interstitial lung disease: does the sequence and timing of therapy matter? Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-11 Meena Kalluri, Subhabrata Moitra, Janice Richman-Eisenstat, Giovanni Ferrara, Elisabeth Bendstrup, Kristoffer Maarsaa
Extract We read the report of Ferreira et al. [1] entitled "Regular, low-dose, sustained-release morphine for persisting breathlessness in interstitial lung disease: a randomised, double-blind, placebo-controlled, crossover trial" with great interest and would like to share our experience and address some limitations of this prospective trial. Dyspnoea assessment and management is undoubtedly challenging
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ERJ Advances: interventional bronchoscopy Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-11 Justin L. Garner, Pallav L. Shah, Felix Herth, Dirk-Jan Slebos
Extract The field of interventional bronchoscopy is rapidly growing, with the development of minimally invasive approaches and innovative devices to diagnose and treat a spectrum of respiratory diseases (figure 1), often as outpatient procedures, and supported by high quality collaborative research. This short review covers aspects related to COPD, peripheral pulmonary nodules, interstitial lung disease
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The carbon footprint of as-needed budesonide/formoterol in mild asthma: a post hoc analysis Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-11 Lee Hatter, Mark Holliday, Allie Eathorne, Pepa Bruce, Ian D. Pavord, Helen K. Reddel, Robert J. Hancox, Alberto Papi, Mark Weatherall, Richard Beasley
Introduction The use of pressurised metered-dose inhalers (pMDIs) and asthma exacerbations necessitating healthcare reviews contribute substantially to the global carbon footprint of healthcare. It is possible that a reduction in carbon footprint could be achieved by switching patients with mild asthma from salbutamol pMDI reliever-based therapy to inhaled corticosteroid-formoterol dry powder inhaler
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Benralizumab in severe eosinophilic asthma by previous biologic use and key clinical subgroups: real-world XALOC-1 programme Eur. Respir. J. (IF 16.6) Pub Date : 2024-07-11 David J. Jackson, Girolamo Pelaia, Benjamin Emmanuel, Trung N. Tran, David Cohen, Vivian H. Shih, Anat Shavit, Douglas Arbetter, Rohit Katial, Adrian Paul J. Rabe, Esther Garcia Gil, Marisa Pardal, Javier Nuevo, Michael Watt, Silvia Boarino, Sheena Kayaniyil, Cláudia Chaves Loureiro, Alicia Padilla-Galo, Parameswaran Nair
Background Pivotal phase 3 trials and real-world studies have demonstrated benralizumab's overall efficacy and safety in severe eosinophilic asthma (SEA). Additional large-cohort data are needed to confirm its real-world effectiveness in SEA according to previous biologic use and key baseline characteristics important for treatment selection. Methods XALOC-1 is a large, multinational, retrospective
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Moving the needle on proteasome inhibitor-induced pulmonary arterial hypertension: a definite maybe Eur. Respir. J. (IF 16.6) Pub Date : 2024-06-28 Brandon Budhram, Roham T. Zamanian, Jason Weatherald
Extract Drug- or toxin-induced pulmonary arterial hypertension (DPAH) is a rare form of group 1 pulmonary arterial hypertension (PAH). In the current PAH classification, the association between drugs or toxins and PAH can either be categorised as "definite" or "possible", with definite associations requiring data from outbreaks, epidemiological case–control studies, and/or large multicentre cohort
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Pleural mesothelioma: surgery questioned again? Eur. Respir. J. (IF 16.6) Pub Date : 2024-06-28 José M. Porcel
Extract Pleural mesothelioma is a rare malignant tumour of the mesothelial cells that poses diagnostic and therapeutic challenges. Patients often experience a gradual onset of dyspnoea, which can be attributed to unilateral pleural effusions and/or diffuse pleural thickening, as well as chest pain [1]. In Europe, there were 14 741 new cases in 2022, most of which occurred in the UK (22%), Italy (16%)