Respiratory Muscle Strength as a Predictor of Exacerbations in Patients With Chronic Obstructive Pulmonary Disease

Respirology, Год журнала: 2025, Номер unknown

Опубликована: Фев. 26, 2025

Chronic obstructive pulmonary disease (COPD) is closely related to skeletal muscle dysfunction, and the evaluation of respiratory function has recently been recommended. We aimed investigate effects dysfunction on clinical outcomes. retrospectively reviewed medical records patients with COPD whose strength was measured between June 2015 December 2021. then analysed moderate-to-severe exacerbations after adjusting for confounding factors, including sex, age, forced expiratory volume in 1-s percent predicted, hand grip strength, mass index. also compared temporal relationship systemic dysfunctions. Respiratory weakness (RMW) observed 48.1% (100) 208 patients. Low predicted maximal inspiratory pressure an independent risk factor within 1 year Cox regression analysis (adjusted hazard ratio per standard deviation increase, 0.521; 95% confidence interval, 0.317-0.856). Approximately half already exhibited RMW at mild while those sarcopenia had higher rates. More experienced progressive without RMW. Lower associated increased exacerbation. could serve as a marker status early prognosis COPD.

Язык: Английский

---

A Long-Term Study of Adverse Outcomes Associated With Oral Corticosteroid Use in COPD

International Journal of COPD, Год журнала: 2023, Номер Volume 18, С. 2565 - 2580

Опубликована: Ноя. 1, 2023

Oral corticosteroids (OCS) are often prescribed for chronic obstructive pulmonary disease (COPD) exacerbations.This observational, individually matched historical cohort study used electronic medical records (1987-2019) from the UK Clinical Practice Research Datalink linked to English Hospital Episode Statistics (HES) evaluate adverse outcomes in patients with COPD who OCS (OCS cohort) and those not exposed (non-OCS cohort). Risk of 17 was estimated using proportional hazard regression.Of 323,722 patients, 106,775 (33.0%) had COPD-related prescriptions. Of overall cohort, 58,955 HES linkage were eligible inclusion cohort. The individual matching process identified 53,299 pairs form non-OCS cohorts. Median follow-up post-index 6.9 years 5.4 Adjusted risk multiple higher versus including osteoporosis with/without fractures (adjusted ratio [aHR] 1.80; 95% confidence interval [CI] 1.70-1.92), type 2 diabetes mellitus (aHR 1.44; CI 1.37-1.51), cardiovascular/cerebrovascular 1.26; 1.21-1.30), all-cause mortality 1.04; 1.02-1.07). In most increased increasing categorized cumulative dose. For example, 34% 1.0-<2.5 g group <0.5 (HR 1.34; 1.26-1.42).Any use associated COPD, generally greater

Язык: Английский

---

Quantifying sustained health system benefits of primary care-based integrated disease management for COPD: a 6-year interrupted time series study

Thorax, Год журнала: 2024, Номер 79(8), С. 725 - 734

Опубликована: Июнь 18, 2024

Severe exacerbation of chronic obstructive pulmonary disease (COPD) is a trajectory-changing life event for patients and major contributor to health system costs. This study evaluates the real-world impact primary care, integrated management (IDM) programme on acute service utilisation (HSU) in Canadian system.

Язык: Английский

---

A Novel Metabolic Score for Predicting the Acute Exacerbation in Patients with Chronic Obstructive Pulmonary Disease

International Journal of COPD, Год журнала: 2023, Номер Volume 18, С. 785 - 795

Опубликована: Май 1, 2023

Chronic obstructive pulmonary disease (COPD) has higher mortality when developing to acute exacerbation (AECOPD); hence, the early intervention of COPD is critical for preventing AECOPD. Exploring serum metabolites associated with in patients will contribute COPD.In study, a non-targeted metabolomics strategy combined multivariate statistical methods was performed explore metabolic profiling exacerbation, screen potential AECOPD and analyze value these predicting development COPD.Serum lysine, glutamine, 3-hydroxybutyrate, pyruvate glutamate levels were significantly higher, while 1-methylhistidine, isoleucine, choline, valine, alanine, histidine leucine lower patients, compared stable after normalization based on healthy controls. Moreover, eight pathways altered (P<0.05) population, including purine metabolism, glutamine arginine biosynthesis, butyrate ketone body synthesis degradation, linoleic acid metabolism. In addition, correlation analysis between demonstrated that an M-score weighted sum concentrations four pyruvate, 1-methylhistidine ventilation function patients.Altogether, metabolite score increased risk which provide new insight understanding development.

Язык: Английский

---

Lower mean corpuscular hemoglobin levels as a predictive factor of future exacerbations in patients with chronic obstructive pulmonary disease

Respiratory Investigation, Год журнала: 2025, Номер 63(1), С. 183 - 190

Опубликована: Янв. 1, 2025

Язык: Английский

---

Cumulative Dispensing of Oral Corticosteroids Over 12 Months in People with COPD

International Journal of COPD, Год журнала: 2025, Номер Volume 20, С. 149 - 158

Опубликована: Янв. 1, 2025

Oral corticosteroids (OCS) are recommended for the treatment of exacerbations in people with COPD; however, high cumulative lifetime doses (≥1000mg prednisolone-equivalent) associated adverse health effects. This issue is well defined asthma but less understood COPD. The aim this study was to examine OCS dispensed COPD over 12 months. a secondary analysis data from two randomised controlled trials involving followed up months following pulmonary rehabilitation. Clinical and administrative (respiratory-related hospital admissions emergency presentations, maintenance medications) were examined determine dose relative 1000mg threshold relationship clinical features. Of 232 participants (126 females, age mean 68 ± SD 9 years, FEV1 53 22% predicted), 48% (n = 112) at least once Sixty-two (26%) ≥1000mg. Participants more likely have had respiratory admission (OR 4.1, 95% CI 2.3 8.7) greater breathlessness (modified Medical Research Council scale ≥2, OR 2.5, 1.3 5.0); no disease severity or medications demonstrated. One four unsafe period only Further work needed magnitude strategies address exposure OCS.

Язык: Английский

---

Ensifentrine in COPD patients taking long-acting bronchodilators: A pooled post-hoc analysis of the ENHANCE-1/2 studies

Chronic Respiratory Disease, Год журнала: 2025, Номер 22

Опубликована: Янв. 24, 2025

Background The efficacy and safety of ensifentrine, a novel PDE3/PDE4 inhibitor, were previously evaluated in the ENHANCE-1 (NCT04535986) ENHANCE-2 (NCT04542057) trials. Here, we present pooled post-hoc subgroup analysis patients according to background chronic obstructive pulmonary disease (COPD) maintenance medication regimens. Objective This aimed explore ensifentrine receiving long-acting muscarinic antagonists (LAMA) or beta-agonists with inhaled corticosteroids (LABA + ICS). Methods Eligible had moderate severe COPD, aged 40–80 years, symptomatic at randomization. Patients randomized 5:3, twice-daily 3 mg placebo via standard jet nebulizer over 24 weeks. Results included 485 LAMA 272 LABA ICS patients. Ensifentrine showed lung function improvement week 12, including average FEV 1 AUC 0–12 h (placebo-corrected least squares mean change from baseline [LSMC], 92 mL; 95% CI, 54, 131; p < 0.001) subgroups (LSMC, 74 27, 121; = 0.002). reduced rate risk exacerbations both (48% 50%, respectively) (51% 56%, subgroups. Ensifentrine-treated reported symptoms quality life profile each was similar modified intention-to-treat population. Conclusions Nebulized offers non-steroidal anti-inflammatory bronchodilator treatment added existing options severe, COPD.

Язык: Английский

---

NTHi killing activity is reduced in COPD patients and is associated with a differential microbiome

Respiratory Research, Год журнала: 2025, Номер 26(1)

Опубликована: Янв. 30, 2025

Язык: Английский

---

Frequency of Exacerbations of Chronic Obstructive Pulmonary Disease Associated with the Long-Term Exposure to Air Pollution in the AIREPOC Cohort

International Journal of COPD, Год журнала: 2025, Номер Volume 20, С. 425 - 435

Опубликована: Фев. 1, 2025

Exacerbations of chronic obstructive pulmonary disease (COPD-E) have been associated with levels air pollution. The occurrence COPD-E is increased mortality in this population. To determine the association between long-term exposure to PM2.5 and NO2, frequency patients belonging AIREPOC, an institutional integrated care program for COPD Bogota, Colombia. Retrospective cohort study included living Bogotá, 2018 2021, who received health AIREPOC program. Each patient´s home address was geolocated. Information from local quality network stations used estimate daily annual mean NO2 level each patient using inverse distance squared weighted regression (IDWR) method. effect concentrations categorized at 15 µg/m3 25 respectively on estimated a zero-truncated negative binomial model adjusted potential confounders. Goodness-of-fit assessed by residuals. During observation period, 580 occurred 722 patients. Significant associations were found ≥25 (incidence density ratio, RDI: 1.29, 95% CI: 1.02-1.67) after adjustment sun exposure, severity, depression, ambient humidity. No ≥15µg/m3. Prolonged high increases exacerbations residing Bogotá. These results highlight importance strengthening control measures educating people know interpret indices follow recommendations derived its alterations.

Язык: Английский

---

The Acute Effects of Motor Imagery Combined With Action Observation Breathing Exercise on Cardiorespiratory Responses, Brain Activity, and Cognition: A Randomized, Controlled Trial

Cardiovascular Therapeutics, Год журнала: 2025, Номер 2025(1)

Опубликована: Янв. 1, 2025

Breath and brain activity have been integral to daily life since time immemorial. Cognition cardiorespiratory responses are closely interlinked, necessitating further investigation into their dynamics. The potential benefits of combining motor imagery (MI) action observation (AO) based breathing exercises in rehabilitation not fully explored. This study was aimed at assessing the acute effects MI combined with AO on cognitive function responses. Thirty‐three healthy adults were randomized (MI+AO), active respiratory exercise (ARE), control groups, equal distribution across groups. Electroencephalography (EEG) data collected using a Muse EEG headband, assessed Montreal Cognitive Assessment (MoCA) while imagining activities measured via Kinesthetic Visual Imagery Questionnaire (KVIQ). Significant improvements Timed Up Go (TUG) test systolic blood pressure observed ARE group ( p < 0.05), alongside MoCA KVIQ scores 0.05). revealed significant decreases delta theta power temporoparietal (TP) location These findings suggest that AO, when exercises, may serve as effective passive strategies support cognition function, particularly individuals who struggle actively participate pulmonary rehabilitation. Trial Registration: ClinicalTrials.gov identifier: NCT06099483

Язык: Английский

---