Respiratory investigation最新文献_第4页

Long-term effects of inhaled treprostinil in Japanese patients with pulmonary hypertension associated with interstitial lung disease 日本肺高血压合并间质性肺病患者吸入曲前列替尼的长期疗效

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-12-15 DOI: 10.1016/j.resinv.2025.101340

Yasuhiro Kondoh , Takashi Ogura , Osamu Nishiyama , Hideyuki Kinoshita , Takeshi Ogo , Nobuhiro Tanabe , Shun Minatsuki , Kazuhiko Nakayama , Yu Taniguchi , Kenta Takahashi , Takashi Orido , Seiichiro Sakao

Background

Treprostinil has been approved for pulmonary hypertension associated with interstitial lung disease (PH-ILD) in Japan. This report aimed to evaluate long-term effects of inhaled treprostinil in Japanese patients with PH-ILD based on observation over 52 weeks.

Methods

Inhaled treprostinil was administered via a nebulizer from 18 μg (three breaths, four times daily) to 72 μg (12 breaths, four times daily) at minimum 3-day intervals. World Health Organization (WHO) functional class, clinical worsening, adverse events, pulmonary function and ILD-related biomarkers were evaluated throughout the trial.

Results

Among 20 patients, 16 and 13 completed the 52-week and 100-week observation periods, respectively. Eleven patients continued on the trial until transitioning to a commercially available product. The reasons of discontinuation in nine patients were adverse events in six patients (including four adverse drug reactions (ADRs)), withdrawal of consent in two patients, and lung transplantation in one patient. The median observation period was 107.5 weeks (interquartile range, 61.4–128.8 weeks) in 20 patients. Among 13 patients observed until week 100, WHO functional class was maintained in 69.2 % (9/13), and improved from class III to class II in 30.8 % (4/13). The main ADRs included cough, malaise, and blood pressure decreased. At the final measurement timepoint in each patient, 70.0 % (14/20) and 83.3 % (15/18) maintained had no absolute decline of forced vital capacity ≥5 % and diffusing capacity for carbon monoxide ≥10 %, respectively.

Conclusion

Considering its long-term clinical benefits and tolerability, inhaled treprostinil is a promising treatment option for patients with PH-ILD.

Trial registration

Japan Registry of Clinical Trials (jRCT), jRCT2051210016. (first registered: May 7, 2021).

背景：在日本，曲前列地尼已被批准用于治疗与间质性肺疾病（PH-ILD）相关的肺动脉高压。本报告旨在基于52周的观察，评估吸入曲前列尼对日本PH-ILD患者的长期影响。方法：用雾化雾化器给药，剂量从18 μg（3次呼吸，每日4次）至72 μg（12次呼吸，每日4次），间隔至少3天。在整个试验过程中，对世界卫生组织（WHO）的功能分类、临床恶化、不良事件、肺功能和ild相关生物标志物进行了评估。结果：20例患者中，分别有16例和13例完成了52周和100周的观察期。11名患者继续进行试验，直到过渡到一种市售产品。9例患者停药原因为6例不良事件（包括4例药物不良反应），2例患者撤回同意，1例患者肺移植。20例患者的中位观察期为107.5周（四分位数间距为61.4 ~ 128.8周）。在观察到第100周的13例患者中，69.2%（9/13）的患者维持WHO功能等级，30.8%（4/13）的患者从III级改善到II级。主要不良反应包括咳嗽、不适和血压下降。在每个患者的最后测量时间点，70.0%（14/20）和83.3%（15/18）的患者维持的强制肺活量≥5%和一氧化碳弥散量≥10%没有绝对下降。结论：考虑到长期临床疗效和耐受性，吸入曲前列地尼是PH-ILD患者的一种有希望的治疗选择。试验注册：日本临床试验注册中心（jRCT）， jRCT2051210016。（首次注册日期：2021年5月7日）。

{"title":"Long-term effects of inhaled treprostinil in Japanese patients with pulmonary hypertension associated with interstitial lung disease","authors":"Yasuhiro Kondoh , Takashi Ogura , Osamu Nishiyama , Hideyuki Kinoshita , Takeshi Ogo , Nobuhiro Tanabe , Shun Minatsuki , Kazuhiko Nakayama , Yu Taniguchi , Kenta Takahashi , Takashi Orido , Seiichiro Sakao","doi":"10.1016/j.resinv.2025.101340","DOIUrl":"10.1016/j.resinv.2025.101340","url":null,"abstract":"<div><h3>Background</h3><div>Treprostinil has been approved for pulmonary hypertension associated with interstitial lung disease (PH-ILD) in Japan. This report aimed to evaluate long-term effects of inhaled treprostinil in Japanese patients with PH-ILD based on observation over 52 weeks.</div></div><div><h3>Methods</h3><div>Inhaled treprostinil was administered via a nebulizer from 18 μg (three breaths, four times daily) to 72 μg (12 breaths, four times daily) at minimum 3-day intervals. World Health Organization (WHO) functional class, clinical worsening, adverse events, pulmonary function and ILD-related biomarkers were evaluated throughout the trial.</div></div><div><h3>Results</h3><div>Among 20 patients, 16 and 13 completed the 52-week and 100-week observation periods, respectively. Eleven patients continued on the trial until transitioning to a commercially available product. The reasons of discontinuation in nine patients were adverse events in six patients (including four adverse drug reactions (ADRs)), withdrawal of consent in two patients, and lung transplantation in one patient. The median observation period was 107.5 weeks (interquartile range, 61.4–128.8 weeks) in 20 patients. Among 13 patients observed until week 100, WHO functional class was maintained in 69.2 % (9/13), and improved from class III to class II in 30.8 % (4/13). The main ADRs included cough, malaise, and blood pressure decreased. At the final measurement timepoint in each patient, 70.0 % (14/20) and 83.3 % (15/18) maintained had no absolute decline of forced vital capacity ≥5 % and diffusing capacity for carbon monoxide ≥10 %, respectively.</div></div><div><h3>Conclusion</h3><div>Considering its long-term clinical benefits and tolerability, inhaled treprostinil is a promising treatment option for patients with PH-ILD.</div></div><div><h3>Trial registration</h3><div>Japan Registry of Clinical Trials (jRCT), jRCT2051210016. (first registered: May 7, 2021).</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 1","pages":"Article 101340"},"PeriodicalIF":2.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769039","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}

引用次数: 0

Oscillometrically assessed higher respiratory reactance is associated with impaired lung function and poorer prognosis in patients with fibrotic idiopathic interstitial pneumonias 在纤维化特发性间质性肺炎患者中，经振荡计量学评估的高呼吸阻抗与肺功能受损和预后较差相关

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-12-13 DOI: 10.1016/j.resinv.2025.101352

Yuya Yamamoto , Taisuke Akamatsu , Keita Hirai , Toshihiro Shirai

Background

Fibrotic idiopathic interstitial pneumonias (IIPs) are progressive lung diseases with variable prognoses. Oscillometry, a non-invasive method for assessing respiratory impedance, has emerged as a potential tool for disease stratification. However, the association between standardized respiratory reactance (Xrs) measured by oscillometry and clinical outcomes in IIPs, including those other than idiopathic pulmonary fibrosis, remains unclear. Therefore, we investigated this association.

Methods

We retrospectively analyzed 101 patients with fibrotic IIPs treated at Shizuoka General Hospital from 2017 to 2022. Fibrosis was defined by high-resolution computed tomography findings of honeycombing, traction bronchiectasis, or subpleural reticulation. Patients were categorized into high-Xrs or low-Xrs groups based on whether Xrs parameters (X5, Fres, or AX) exceeded 1.64 standard deviations above Japanese standard values. The primary outcome was mortality. Cox proportional hazards analysis identified prognostic factors.

Results

Among 101 patients, 25 (24.8 %) were classified as high-Xrs. Median overall survival was significantly shorter in the high-Xrs group (21.1 months; 95 % CI, 13.2–43.3) compared to the low-Xrs group (78.7 months; 95 % CI, 56.8–not reached). A subgroup analysis of IPF and non-IPF patients showed significant survival differences between the high-Xrs and low-Xrs groups. Multivariate analysis identified low %FVC and high-Xrs classification as independent predictors of mortality.

Conclusions

High respiratory reactance measured by oscillometry was independently associated with impaired lung function and poor prognosis in patients with fibrotic IIPs. Oscillometry may be a valuable tool for risk stratification and prognostic assessment in this patient population.

背景：纤维化特发性间质性肺炎（IIPs）是一种预后多变的进行性肺部疾病。振荡测量法是一种评估呼吸阻抗的非侵入性方法，已成为疾病分层的潜在工具。然而，振荡法测量的标准化呼吸电抗（Xrs）与IIPs的临床结果（包括特发性肺纤维化以外的临床结果）之间的关系尚不清楚。因此，我们调查了这种关联。方法回顾性分析2017 - 2022年静冈县总医院收治的101例纤维化IIPs患者。纤维化的定义是高分辨率计算机断层扫描显示蜂窝状、牵引支气管扩张或胸膜下网状。根据Xrs参数（X5、Fres或AX）是否超过日本标准值1.64个标准差，将患者分为高Xrs组或低Xrs组。主要结局是死亡率。Cox比例风险分析确定了预后因素。结果101例患者中有25例（24.8%）为高x线反射值。高xrs组的中位总生存期（21.1个月，95% CI, 13.2-43.3）明显短于低xrs组（78.7个月，95% CI， 56.8 -未达到）。对IPF和非IPF患者的亚组分析显示，高xrs组和低xrs组之间存在显著的生存差异。多变量分析发现低FVC百分比和高xrs分类是死亡率的独立预测因子。结论振荡法测量的高呼吸电抗与纤维化IIPs患者肺功能受损和预后不良有独立的相关性。振荡测量法可能是这类患者风险分层和预后评估的一种有价值的工具。

{"title":"Oscillometrically assessed higher respiratory reactance is associated with impaired lung function and poorer prognosis in patients with fibrotic idiopathic interstitial pneumonias","authors":"Yuya Yamamoto , Taisuke Akamatsu , Keita Hirai , Toshihiro Shirai","doi":"10.1016/j.resinv.2025.101352","DOIUrl":"10.1016/j.resinv.2025.101352","url":null,"abstract":"<div><h3>Background</h3><div>Fibrotic idiopathic interstitial pneumonias (IIPs) are progressive lung diseases with variable prognoses. Oscillometry, a non-invasive method for assessing respiratory impedance, has emerged as a potential tool for disease stratification. However, the association between standardized respiratory reactance (Xrs) measured by oscillometry and clinical outcomes in IIPs, including those other than idiopathic pulmonary fibrosis, remains unclear. Therefore, we investigated this association.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 101 patients with fibrotic IIPs treated at Shizuoka General Hospital from 2017 to 2022. Fibrosis was defined by high-resolution computed tomography findings of honeycombing, traction bronchiectasis, or subpleural reticulation. Patients were categorized into high-Xrs or low-Xrs groups based on whether Xrs parameters (X5, Fres, or AX) exceeded 1.64 standard deviations above Japanese standard values. The primary outcome was mortality. Cox proportional hazards analysis identified prognostic factors.</div></div><div><h3>Results</h3><div>Among 101 patients, 25 (24.8 %) were classified as high-Xrs. Median overall survival was significantly shorter in the high-Xrs group (21.1 months; 95 % CI, 13.2–43.3) compared to the low-Xrs group (78.7 months; 95 % CI, 56.8–not reached). A subgroup analysis of IPF and non-IPF patients showed significant survival differences between the high-Xrs and low-Xrs groups. Multivariate analysis identified low %FVC and high-Xrs classification as independent predictors of mortality.</div></div><div><h3>Conclusions</h3><div>High respiratory reactance measured by oscillometry was independently associated with impaired lung function and poor prognosis in patients with fibrotic IIPs. Oscillometry may be a valuable tool for risk stratification and prognostic assessment in this patient population.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 1","pages":"Article 101352"},"PeriodicalIF":2.0,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736941","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}

引用次数: 0

Identification of individuals with COPD using biometric voice and cough sound features 使用生物识别声音和咳嗽声特征识别COPD患者

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-12-12 DOI: 10.1016/j.resinv.2025.101353

Yasushi Obase , Susumu Fukahori , Jun Iriki , Takahiro Takazono , Yusei Tsukamoto , Shinnosuke Takemoto , Noriho Sakamoto , Yusuke Hamanaka , Hideaki Watanabe , Kazumi Hirano , Chizu Fukushima , Tomoya Nishino , Hiroshi Mukae

Background

Chronic obstructive pulmonary disease (COPD), a major global health burden linked to smoking, is frequently underdiagnosed due to low awareness and delayed symptom recognition. This study explored the feasibility of non-invasive voice and cough sound analysis for COPD identification.

Methods

In this prospective study, 55 participants (26 with COPD, 29 without) underwent pulmonary function testing and provided sociodemographic and clinical data. Speech and cough sounds were recorded three times per participant and processed using acoustic feature extraction, feature selection via the minimum redundancy maximum relevance algorithm, and logistic regression classification. Model performance was evaluated using four-fold cross-validation. Statistical analysis was conducted with JMP software (p < 0.05).

Results

The vowel sound/u/showed statistically significant discriminatory ability in the mixed-gender cohort, but sensitivity and specificity were both below 80 %, indicating limited diagnostic performance. When restricted to male participants, both metrics exceeded 80 %, suggesting higher discriminatory power. Smartphone recordings yielded comparable accuracy to integrated circuit recorders. Adding COPD assessment test scores and smoking history did not improve classification.

Conclusions

Voice analysis may offer a non-invasive screening approach for COPD. However, this study was limited to male participants and a single disease target, restricting generalizability. Future research will expand to include related respiratory conditions such as bronchiectasis and assess performance across sexes and disease types.

慢性阻塞性肺疾病（COPD）是与吸烟相关的主要全球健康负担，由于认识不足和症状识别延迟，经常被误诊。本研究探讨无创声音和咳嗽声分析在COPD诊断中的可行性。方法在这项前瞻性研究中，55名参与者（26名COPD患者，29名非COPD患者）接受了肺功能测试，并提供了社会人口学和临床数据。每个参与者记录三次语音和咳嗽声音，并使用声学特征提取，通过最小冗余最大相关算法进行特征选择和逻辑回归分类进行处理。采用四重交叉验证评估模型性能。采用JMP软件进行统计学分析（p < 0.05）。结果在混合性别队列中，元音/u/的区分能力有统计学意义，但敏感性和特异性均低于80%，诊断效能有限。当仅限于男性参与者时，这两个指标都超过了80%，表明存在更大的歧视力量。智能手机录音的准确度与集成电路记录仪相当。增加COPD评估测试分数和吸烟史并没有改善分类。结论语音分析可能是COPD的一种无创筛查方法。然而，这项研究仅限于男性参与者和单一疾病目标，限制了普遍性。未来的研究将扩大到包括相关的呼吸系统疾病，如支气管扩张，并评估性别和疾病类型的表现。

{"title":"Identification of individuals with COPD using biometric voice and cough sound features","authors":"Yasushi Obase , Susumu Fukahori , Jun Iriki , Takahiro Takazono , Yusei Tsukamoto , Shinnosuke Takemoto , Noriho Sakamoto , Yusuke Hamanaka , Hideaki Watanabe , Kazumi Hirano , Chizu Fukushima , Tomoya Nishino , Hiroshi Mukae","doi":"10.1016/j.resinv.2025.101353","DOIUrl":"10.1016/j.resinv.2025.101353","url":null,"abstract":"<div><h3>Background</h3><div>Chronic obstructive pulmonary disease (COPD), a major global health burden linked to smoking, is frequently underdiagnosed due to low awareness and delayed symptom recognition. This study explored the feasibility of non-invasive voice and cough sound analysis for COPD identification.</div></div><div><h3>Methods</h3><div>In this prospective study, 55 participants (26 with COPD, 29 without) underwent pulmonary function testing and provided sociodemographic and clinical data. Speech and cough sounds were recorded three times per participant and processed using acoustic feature extraction, feature selection via the minimum redundancy maximum relevance algorithm, and logistic regression classification. Model performance was evaluated using four-fold cross-validation. Statistical analysis was conducted with JMP software (p < 0.05).</div></div><div><h3>Results</h3><div>The vowel sound/u/showed statistically significant discriminatory ability in the mixed-gender cohort, but sensitivity and specificity were both below 80 %, indicating limited diagnostic performance. When restricted to male participants, both metrics exceeded 80 %, suggesting higher discriminatory power. Smartphone recordings yielded comparable accuracy to integrated circuit recorders. Adding COPD assessment test scores and smoking history did not improve classification.</div></div><div><h3>Conclusions</h3><div>Voice analysis may offer a non-invasive screening approach for COPD. However, this study was limited to male participants and a single disease target, restricting generalizability. Future research will expand to include related respiratory conditions such as bronchiectasis and assess performance across sexes and disease types.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 1","pages":"Article 101353"},"PeriodicalIF":2.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736906","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}

引用次数: 0

High-intensity inspiratory muscle training and diaphragm thickness in severe COPD: a prospective pilot study 重度COPD患者的高强度吸气肌训练和膈肌厚度：一项前瞻性先导研究

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-12-12 DOI: 10.1016/j.resinv.2025.101348

Daisuke Minamishima , Yuko Asato , Kazuhiro Tsuji , Rin Anamizu , Nami Hasegawa , Daisuke Shiihara

High-intensity inspiratory muscle training (IMT) has been reported to increase diaphragm thickness in healthy adults, but evidence in severe chronic obstructive pulmonary disease (COPD) remains scarce. This prospective pilot study evaluated the effects of high-intensity IMT on diaphragm thickness and functional outcomes in nine patients with severe COPD who had completed standard respiratory rehabilitation. Participants performed 30 breaths per day at 60 % of maximum inspiratory pressure for 12 weeks. Diaphragm thickness at maximum inspiration increased from 4.7 to 5.6 mm, maximum inspiratory pressure from 57.1 to 68.1 cmH₂O, 6-min walk distance from 318 to 366 m, and COPD Assessment Test scores from 19 to 12, both exceeding the minimal clinically important difference thresholds (all p < 0.01). These findings suggest that high-intensity IMT may be a feasible and beneficial adjunct for improving inspiratory function and symptoms in patients with severe COPD.

据报道，高强度的吸气肌训练（IMT）可以增加健康成人的横膈膜厚度，但在严重慢性阻塞性肺疾病（COPD）中的证据仍然很少。这项前瞻性试点研究评估了高强度IMT对9例重度COPD患者膈膜厚度和功能结局的影响，这些患者已完成标准呼吸康复。参与者每天以最大吸气压力的60%进行30次呼吸，持续12周。最大吸气时膈膜厚度从4.7增加到5.6 mm，最大吸气压力从57.1增加到68.1 cmH2O， 6分钟步行距离从318增加到366 m， COPD评估测试分数从19增加到12，均超过最小临床重要差异阈值（均p <； 0.01）。这些发现表明，高强度IMT可能是一种可行且有益的辅助手段，可改善严重COPD患者的吸气功能和症状。

引用次数: 0

Impact of bendopnea on indicators of pulmonary hypertension, health-related quality of life, and pulmonary function in patients with chronic obstructive pulmonary disease 弯曲通气对慢性阻塞性肺疾病患者肺动脉高压、健康相关生活质量和肺功能指标的影响

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-12-09 DOI: 10.1016/j.resinv.2025.101346

Toshitaka Shomura , Yosuke Wada , Norihiko Goto , Yusuke Suzuki , Yoshiaki Kitaguchi , Atsuhito Ushiki , Taku Osawa , Masanori Yasuo , Masayuki Hanaoka

Background

Bendopnea is a recognized symptom in patients with systolic heart failure; however, its clinical relevance in those with chronic obstructive pulmonary disease (COPD) has not been fully elucidated. This study aimed to evaluate the potential impact of bendopnea on the coexistence of comorbid pulmonary hypertension (PH), various metrics of health-related quality of life (HRQoL), chest CT findings, and respiratory function in a cohort of patients with COPD.

Methods

This retrospective study analyzed the medical records of 133 patients with COPD at Shinshu University Hospital (Matsumoto, Japan). Bendopnea was defined as a positive response to a bendopnea-related question based on the corresponding item in the St. George's Respiratory Questionnaire (SGRQ). Pulmonary artery and descending aorta diameters were measured on CT scans. To assess emphysema severity, the percentage of low-attenuation volume (LAV%) was calculated from the same CT scans using specialized image analysis software. Respiratory impedance was evaluated using oscillometry. Indicators of PH, emphysema severity, HRQoL, and pulmonary function were compared between patients who reported bendopnea and those who did not.

Results

Compared to those without bendopnea, patients with the symptom had a significantly higher pulmonary artery-to-descending aorta diameter ratio and LAV%, as well as markedly poorer HRQoL. Regarding oscillometry parameters, reactance at 5 Hz (X5) was significantly decreased in the bendopnea group, while elevated resonant frequency (Fres) and area under the low-frequency reactance curve (ALX) values were also observed.

Conclusions

Bendopnea may serve as a clinical indicator of a more advanced disease state in COPD.

背景：腹底通气是收缩期心力衰竭患者公认的症状；然而，其在慢性阻塞性肺疾病（COPD）患者中的临床意义尚未完全阐明。本研究旨在评估benendopnea对COPD患者共病肺动脉高压（PH）共存、各种健康相关生活质量指标（HRQoL）、胸部CT表现和呼吸功能的潜在影响。方法：本回顾性研究分析了日本松本信州大学医院133例COPD患者的病历。弯曲呼吸被定义为对基于圣乔治呼吸问卷（SGRQ）中相应项目的弯曲呼吸相关问题的积极回应。在CT上测量肺动脉和降主动脉的直径。为了评估肺气肿的严重程度，使用专门的图像分析软件计算相同CT扫描的低衰减体积百分比（LAV%）。用振荡法测定呼吸阻抗。比较报告弯曲通气的患者和没有报告弯曲通气的患者的PH、肺气肿严重程度、HRQoL和肺功能指标。结果：有此症状的患者肺动脉降主动脉径比和LAV%明显高于无此症状的患者，HRQoL明显低于无此症状的患者。在振荡参数方面，benendopnea组5 Hz电抗（X5）明显降低，同时共振频率（Fres）和低频电抗曲线下面积（ALX）值也有所升高。结论：弯曲通气可作为慢性阻塞性肺病更晚期疾病状态的临床指标。

{"title":"Impact of bendopnea on indicators of pulmonary hypertension, health-related quality of life, and pulmonary function in patients with chronic obstructive pulmonary disease","authors":"Toshitaka Shomura , Yosuke Wada , Norihiko Goto , Yusuke Suzuki , Yoshiaki Kitaguchi , Atsuhito Ushiki , Taku Osawa , Masanori Yasuo , Masayuki Hanaoka","doi":"10.1016/j.resinv.2025.101346","DOIUrl":"10.1016/j.resinv.2025.101346","url":null,"abstract":"<div><h3>Background</h3><div>Bendopnea is a recognized symptom in patients with systolic heart failure; however, its clinical relevance in those with chronic obstructive pulmonary disease (COPD) has not been fully elucidated. This study aimed to evaluate the potential impact of bendopnea on the coexistence of comorbid pulmonary hypertension (PH), various metrics of health-related quality of life (HRQoL), chest CT findings, and respiratory function in a cohort of patients with COPD.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed the medical records of 133 patients with COPD at Shinshu University Hospital (Matsumoto, Japan). Bendopnea was defined as a positive response to a bendopnea-related question based on the corresponding item in the St. George's Respiratory Questionnaire (SGRQ). Pulmonary artery and descending aorta diameters were measured on CT scans. To assess emphysema severity, the percentage of low-attenuation volume (LAV%) was calculated from the same CT scans using specialized image analysis software. Respiratory impedance was evaluated using oscillometry. Indicators of PH, emphysema severity, HRQoL, and pulmonary function were compared between patients who reported bendopnea and those who did not.</div></div><div><h3>Results</h3><div>Compared to those without bendopnea, patients with the symptom had a significantly higher pulmonary artery-to-descending aorta diameter ratio and LAV%, as well as markedly poorer HRQoL. Regarding oscillometry parameters, reactance at 5 Hz (X5) was significantly decreased in the bendopnea group, while elevated resonant frequency (Fres) and area under the low-frequency reactance curve (ALX) values were also observed.</div></div><div><h3>Conclusions</h3><div>Bendopnea may serve as a clinical indicator of a more advanced disease state in COPD.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 1","pages":"Article 101346"},"PeriodicalIF":2.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145725529","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}

引用次数: 0

Corrigendum to “Factors associated with pulmonary function decline in patients with rheumatoid arthritis-associated interstitial lung disease” [Respir. Investig. Volume 63, Issue 5, Pages 857–865] 《类风湿关节炎相关间质性肺病患者肺功能下降相关因素》的勘误。Investig。第63卷，第5期，857-865页]。

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-12-09 DOI: 10.1016/j.resinv.2025.101345

Takako Kawaguchi , Masahiro Tahara , Kei Yamasaki , Natsumi Tani , Yurie Kanda-Satoh , Takatoshi Aoki , Yoshiya Tanaka , Kazuhiro Yatera

引用次数: 0

To coexist or not to coexist: The evolutionary paradox of the human-microbe relationship 共存还是不共存：人类与微生物关系的进化悖论

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-12-06 DOI: 10.1016/j.resinv.2025.101350

Hajime Fujimoto

引用次数: 0

Ultrasound-guided percutaneous core biopsy of thoracic lesions: Diagnostic yield and site-specific safety 超声引导下胸部病变的经皮穿刺活检：诊断率和部位特异性安全性

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-12-06 DOI: 10.1016/j.resinv.2025.101347

Yosuke Murakami, Shota Sogabe, Kazuki Uchida, Takafumi Kawabata, Hiroaki Ota, Yuri Hiramatsu, Mitsukuni Sakabe, Ryuta Yamamoto, Ryunosuke Oi, Akiko Maeda, Kohei Yoshimine, Saori Nishizawa, Hiromi Ide, Minako Hanaka, Kazunori Tobino

Background

Ultrasound (US)-guided percutaneous biopsy is increasingly being used for thoracic lesions abutting the chest wall; however, its comparative safety according to puncture site remains unclear. We assessed the diagnostic yield and complications of bedside US-guided core needle biopsy.

Methods

We retrospectively reviewed the medical records of 168 consecutive patients who underwent pulmonologist-performed bedside core biopsy using an 18-gauge needle under real-time US guidance without a coaxial system between April 2011 and July 2022 at a single center. Typically, two to three passes were performed. Lesions were prospectively classified ultrasonographically as solid or heterogeneous. Diagnostic yield and complications were graded using the Clavien–Dindo system and compared according to puncture site and lesion morphology.

Results

Adequate tissue was obtained in 159 (94.6 %) patients. The final diagnosis was malignancy, infection, and other benign conditions in 81.8 %, 13.8 %, and 4.4 % patients, respectively. Complications occurred in 7.1 % of patients, and pneumothorax was the most frequent complication (4.7 %). All complications were managed conservatively. Grade IV–V adverse events occurred in three (1.5 %) patients undergoing lung parenchymal biopsies. Of these, one patient died during follow-up due to pleural dissemination along the biopsy tract. No adverse events ≥ Grade III occurred after chest-wall, pleural, or mediastinal biopsies. No adverse events occurred in 156 patients.

Conclusions

US-guided percutaneous core biopsy has a high diagnostic accuracy and low complication rate. However, safety varies according to site, with serious adverse events limited to patients with lung parenchymal targets. US-guided core biopsy is a feasible first-line approach for accessible extrapulmonary thoracic lesions; however, careful consideration is required for intrapulmonary targets.

超声（US）引导下的经皮活检越来越多地用于靠近胸壁的胸部病变；然而，其根据穿刺部位的相对安全性尚不清楚。我们评估了床边穿刺穿刺活检的诊断率和并发症。方法回顾性回顾了2011年4月至2022年7月在单个中心连续168例患者的医疗记录，这些患者在实时美国指导下使用18号针进行了肺科医生的床边核心活检，没有同轴系统。通常，要进行两到三次传递。超声对病变进行前瞻性分类，分为实性病变和异质性病变。采用Clavien-Dindo系统对诊断率和并发症进行分级，并根据穿刺部位和病变形态进行比较。结果159例（94.6%）患者获得足量组织。最终诊断为恶性，感染和其他良性情况分别为81.8%，13.8%和4.4%的患者。并发症发生率为7.1%，其中气胸是最常见的并发症（4.7%）。所有并发症均予保守处理。3例（1.5%）接受肺实质活检的患者发生了IV-V级不良事件。其中，1例患者在随访期间因胸膜沿活检道扩散而死亡。胸壁、胸膜或纵隔活检后未发生≥III级不良事件。156例患者无不良事件发生。结论超声引导下经皮穿刺活检诊断准确率高，并发症发生率低。然而，安全性因部位而异，严重不良事件仅限于肺实质靶的患者。美国引导下的核心活检是一种可行的一线方法，可触及肺外胸部病变；然而，需要仔细考虑肺内目标。

{"title":"Ultrasound-guided percutaneous core biopsy of thoracic lesions: Diagnostic yield and site-specific safety","authors":"Yosuke Murakami, Shota Sogabe, Kazuki Uchida, Takafumi Kawabata, Hiroaki Ota, Yuri Hiramatsu, Mitsukuni Sakabe, Ryuta Yamamoto, Ryunosuke Oi, Akiko Maeda, Kohei Yoshimine, Saori Nishizawa, Hiromi Ide, Minako Hanaka, Kazunori Tobino","doi":"10.1016/j.resinv.2025.101347","DOIUrl":"10.1016/j.resinv.2025.101347","url":null,"abstract":"<div><h3>Background</h3><div>Ultrasound (US)-guided percutaneous biopsy is increasingly being used for thoracic lesions abutting the chest wall; however, its comparative safety according to puncture site remains unclear. We assessed the diagnostic yield and complications of bedside US-guided core needle biopsy.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the medical records of 168 consecutive patients who underwent pulmonologist-performed bedside core biopsy using an 18-gauge needle under real-time US guidance without a coaxial system between April 2011 and July 2022 at a single center. Typically, two to three passes were performed. Lesions were prospectively classified ultrasonographically as solid or heterogeneous. Diagnostic yield and complications were graded using the Clavien–Dindo system and compared according to puncture site and lesion morphology.</div></div><div><h3>Results</h3><div>Adequate tissue was obtained in 159 (94.6 %) patients. The final diagnosis was malignancy, infection, and other benign conditions in 81.8 %, 13.8 %, and 4.4 % patients, respectively. Complications occurred in 7.1 % of patients, and pneumothorax was the most frequent complication (4.7 %). All complications were managed conservatively. Grade IV–V adverse events occurred in three (1.5 %) patients undergoing lung parenchymal biopsies. Of these, one patient died during follow-up due to pleural dissemination along the biopsy tract. No adverse events ≥ Grade III occurred after chest-wall, pleural, or mediastinal biopsies. No adverse events occurred in 156 patients.</div></div><div><h3>Conclusions</h3><div>US-guided percutaneous core biopsy has a high diagnostic accuracy and low complication rate. However, safety varies according to site, with serious adverse events limited to patients with lung parenchymal targets. US-guided core biopsy is a feasible first-line approach for accessible extrapulmonary thoracic lesions; however, careful consideration is required for intrapulmonary targets.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 1","pages":"Article 101347"},"PeriodicalIF":2.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681715","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}

引用次数: 0

Erector spinae muscle thickness predicts mortality in patients with pulmonary diseases 竖脊肌厚度可预测肺部疾病患者的死亡率

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-12-05 DOI: 10.1016/j.resinv.2025.101342

Masafumi Shimoda, Haruka Hamada, Takashi Yoshiyama, Kozo Morimoto, Kozo Yoshimori, Shoji Kudoh

Background and objective

Loss of skeletal muscle mass contributes to poor respiratory disease outcomes. We previously developed an easy method for assessing physical activity by measuring erector spinae muscle thickness (ESM_T) via routine chest computed tomography (CT). Since chest CT is commonly performed in hospitalized patients with pulmonary diseases, ESM_T can be readily evaluated. In this study, we aimed to investigate the association between ESM_T and 1-year mortality in such patients.

Methods

We prospectively enrolled patients hospitalized for pulmonary diseases between February 2023 and January 2024. Among the 636 patients included, 162 died within one year (mortality group), and 474 survived (survival group). ESM_T was compared between the groups, and its correlations with clinical parameters were examined. Subgroup analyses were conducted for patients with major pulmonary conditions to assess the broader clinical utility of ESM_T.

Results

Lower ESM_T was significantly associated with higher 1-year mortality risk according to the Cox proportional hazard model (hazard ratio: 0.96, 95 % confidence interval: 0.92–0.99, p = 0.035). An ESM_T ≤20.55 mm predicted increased mortality risk. Subgroup analyses confirmed the associations between low ESM_T and mortality across pneumonia, interstitial lung disease, chronic obstructive pulmonary disease, and nontuberculous mycobacteria and/or bronchiectasis. ESM_T also correlated significantly with age, males, body weight, body mass index, activities of daily living (ADL), pre-admission living place, use of home oxygen therapy, and SARC-F scores.

Conclusion

ESM_T is a useful and easy marker for predicting 1-year mortality and impaired ADL status in patients with pulmonary diseases.

背景与目的骨骼肌质量的减少与呼吸系统疾病预后不良有关。我们之前开发了一种简单的方法，通过常规胸部计算机断层扫描（CT）测量竖脊肌厚度（ESMT）来评估身体活动。由于胸部CT通常在住院的肺部疾病患者中进行，因此可以很容易地评估ESMT。在这项研究中，我们旨在调查ESMT与此类患者1年死亡率之间的关系。方法前瞻性纳入2023年2月至2024年1月期间因肺部疾病住院的患者。纳入的636例患者中，一年内死亡162例（死亡组），存活474例（生存组）。比较各组间的ESMT，并分析其与临床参数的相关性。对主要肺部疾病患者进行亚组分析，以评估ESMT更广泛的临床应用。结果Cox比例风险模型显示，较低的ESMT与较高的1年死亡风险显著相关（风险比为0.96,95%可信区间为0.92 ~ 0.99,p = 0.035）。ESMT≤20.55 mm预测死亡风险增加。亚组分析证实了低ESMT与肺炎、间质性肺疾病、慢性阻塞性肺疾病、非结核分枝杆菌和/或支气管扩张的死亡率之间的关联。ESMT还与年龄、男性、体重、体重指数、日常生活活动（ADL）、入院前居住地点、家庭氧疗使用和SARC-F评分显著相关。结论esmt是预测肺部疾病患者1年死亡率和ADL受损状况的有效、简便的指标。

{"title":"Erector spinae muscle thickness predicts mortality in patients with pulmonary diseases","authors":"Masafumi Shimoda, Haruka Hamada, Takashi Yoshiyama, Kozo Morimoto, Kozo Yoshimori, Shoji Kudoh","doi":"10.1016/j.resinv.2025.101342","DOIUrl":"10.1016/j.resinv.2025.101342","url":null,"abstract":"<div><h3>Background and objective</h3><div>Loss of skeletal muscle mass contributes to poor respiratory disease outcomes. We previously developed an easy method for assessing physical activity by measuring erector spinae muscle thickness (ESM<sub>T</sub>) via routine chest computed tomography (CT). Since chest CT is commonly performed in hospitalized patients with pulmonary diseases, ESM<sub>T</sub> can be readily evaluated. In this study, we aimed to investigate the association between ESM<sub>T</sub> and 1-year mortality in such patients.</div></div><div><h3>Methods</h3><div>We prospectively enrolled patients hospitalized for pulmonary diseases between February 2023 and January 2024. Among the 636 patients included, 162 died within one year (mortality group), and 474 survived (survival group). ESM<sub>T</sub> was compared between the groups, and its correlations with clinical parameters were examined. Subgroup analyses were conducted for patients with major pulmonary conditions to assess the broader clinical utility of ESM<sub>T</sub>.</div></div><div><h3>Results</h3><div>Lower ESM<sub>T</sub> was significantly associated with higher 1-year mortality risk according to the Cox proportional hazard model (hazard ratio: 0.96, 95 % confidence interval: 0.92–0.99, <em>p</em> = 0.035). An ESM<sub>T</sub> ≤20.55 mm predicted increased mortality risk. Subgroup analyses confirmed the associations between low ESM<sub>T</sub> and mortality across pneumonia, interstitial lung disease, chronic obstructive pulmonary disease, and nontuberculous mycobacteria and/or bronchiectasis. ESM<sub>T</sub> also correlated significantly with age, males, body weight, body mass index, activities of daily living (ADL), pre-admission living place, use of home oxygen therapy, and SARC-F scores.</div></div><div><h3>Conclusion</h3><div>ESM<sub>T</sub> is a useful and easy marker for predicting 1-year mortality and impaired ADL status in patients with pulmonary diseases.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 1","pages":"Article 101342"},"PeriodicalIF":2.0,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681717","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}

引用次数: 0

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-12-04 DOI: 10.1016/j.resinv.2025.101343

Chikashi Iwasaki , Kumi Nakaya , Mitsuhiro Yamada , Naoki Nakaya , Mana Kogure , Rieko Hatanaka , Ippei Chiba , Masato Takase , Sayuri Tokioka , Taku Obara , Masatsugu Orui , Naoya Fujino , Akira Koarai , Tomoko Kobayashi , Yohei Hamanaka , Eiichi N Kodama , Satoshi Nagaie , Soichi Ogishima , Nobuo Fuse , Shinichi Kuriyama , Atsushi Hozawa

Background

Preserved ratio impaired spirometry (PRISm), defined as a forced expiratory volume in 1 s (FEV₁) to forced vital capacity (FVC) ratio ≥0.70 and a predicted FEV₁ <80 %, is associated with increased morbidity and mortality. However, determinants of PRISm, particularly in younger populations, remain poorly characterised. We aimed to address this knowledge gap.

Methods

We conducted a cross-sectional analysis of 12,350 participants from a Japanese community-based cohort using data from the Tohoku Medical Megabank Project. Participants underwent spirometry, blood pressure measurement, laboratory testing, and completed standardised questionnaires. Multivariate logistic regression was used to identify factors associated with PRISm across three age groups: 20–39, 40–59, and ≥60 years. Interactions between age groups and other explanatory variables were assessed.

Results

In the 20–39-year group, PRISm was independently associated with being men, diabetes mellitus, hypothyroidism, and low body mass index (BMI <18.5 kg/m²), and inversely associated with age. Among participants aged ≥60 years, PRISm was significantly associated with increasing age, overweight status (BMI ≥25.0–<30.0 kg/m²), being men, current smoking, hypertension, diabetes mellitus, bronchial asthma, elevated eosinophil counts (≥300 cells/μL), and birth weight ≥2000–<2500 g. Significant interactions were observed between age and BMI, bronchial asthma, and thyroid dysfunction.

Conclusions

Our findings indicate that PRISm in younger adults is associated with hypothyroidism and underweight status, whereas in older adults, it is more closely related to constitutional and lifestyle-related factors. These results highlight the heterogeneity of PRISm and indicate that its pathophysiology and optimal management may vary by age group.

保留比例肺功能受损（PRISm），定义为1秒内用力呼气量（FEV1）与用力肺活量（FVC）之比≥0.70，预测FEV1≥80%，与发病率和死亡率增加相关。然而，PRISm的决定因素，特别是在年轻人群中，仍然缺乏特征。我们的目标是解决这一知识差距。方法我们对来自日本社区队列的12,350名参与者进行了横断面分析，数据来自东北医疗大银行项目。参与者接受肺活量测定、血压测量、实验室测试，并完成标准化问卷调查。多因素logistic回归用于确定三个年龄组（20-39岁、40-59岁和≥60岁）与PRISm相关的因素。评估了年龄组和其他解释变量之间的相互作用。结果在20 - 39岁组中，PRISm与男性、糖尿病、甲状腺功能减退、低体重指数（BMI <18.5 kg/m2）独立相关，与年龄负相关。在年龄≥60岁的参与者中，PRISm与年龄增长、超重状态（BMI≥25.0 - 30.0 kg/m2）、男性、当前吸烟、高血压、糖尿病、支气管哮喘、嗜酸性粒细胞计数升高（≥300个细胞/μL）和出生体重≥2000 - 2500 g显著相关。观察到年龄与BMI、支气管哮喘和甲状腺功能障碍之间存在显著的相互作用。结论青壮年PRISm与甲状腺功能减退、体重过轻有关，而老年人PRISm与体质、生活方式等因素关系更密切。这些结果突出了PRISm的异质性，并表明其病理生理和最佳管理可能因年龄组而异。

{"title":"Age-related factors associated with preserved ratio impaired spirometry: The Tohoku medical Megabank project community-based cohort study","authors":"Chikashi Iwasaki , Kumi Nakaya , Mitsuhiro Yamada , Naoki Nakaya , Mana Kogure , Rieko Hatanaka , Ippei Chiba , Masato Takase , Sayuri Tokioka , Taku Obara , Masatsugu Orui , Naoya Fujino , Akira Koarai , Tomoko Kobayashi , Yohei Hamanaka , Eiichi N Kodama , Satoshi Nagaie , Soichi Ogishima , Nobuo Fuse , Shinichi Kuriyama , Atsushi Hozawa","doi":"10.1016/j.resinv.2025.101343","DOIUrl":"10.1016/j.resinv.2025.101343","url":null,"abstract":"<div><h3>Background</h3><div>Preserved ratio impaired spirometry (PRISm), defined as a forced expiratory volume in 1 s (FEV<sub>1</sub>) to forced vital capacity (FVC) ratio ≥0.70 and a predicted FEV<sub>1</sub> <80 %, is associated with increased morbidity and mortality. However, determinants of PRISm, particularly in younger populations, remain poorly characterised. We aimed to address this knowledge gap.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional analysis of 12,350 participants from a Japanese community-based cohort using data from the Tohoku Medical Megabank Project. Participants underwent spirometry, blood pressure measurement, laboratory testing, and completed standardised questionnaires. Multivariate logistic regression was used to identify factors associated with PRISm across three age groups: 20–39, 40–59, and ≥60 years. Interactions between age groups and other explanatory variables were assessed.</div></div><div><h3>Results</h3><div>In the 20–39-year group, PRISm was independently associated with being men, diabetes mellitus, hypothyroidism, and low body mass index (BMI <18.5 kg/m<sup>2</sup>), and inversely associated with age. Among participants aged ≥60 years, PRISm was significantly associated with increasing age, overweight status (BMI ≥25.0–<30.0 kg/m<sup>2</sup>), being men, current smoking, hypertension, diabetes mellitus, bronchial asthma, elevated eosinophil counts (≥300 cells/μL), and birth weight ≥2000–<2500 g. Significant interactions were observed between age and BMI, bronchial asthma, and thyroid dysfunction.</div></div><div><h3>Conclusions</h3><div>Our findings indicate that PRISm in younger adults is associated with hypothyroidism and underweight status, whereas in older adults, it is more closely related to constitutional and lifestyle-related factors. These results highlight the heterogeneity of PRISm and indicate that its pathophysiology and optimal management may vary by age group.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 1","pages":"Article 101343"},"PeriodicalIF":2.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681716","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}

引用次数: 0