Publications by authors named "Diego A Rodriguez-Chiaradia"

Lung transplantation (LT) is a well-established therapeutic option for patients with advanced chronic respiratory diseases. This study aims to assess the prevalence and clinical impact of Group 2 pulmonary hypertension (PHg2) in LT recipients, comparing it with Group 3 pulmonary hypertension (PHg3). This retrospective cohort study analyzed LT recipients from 2015 to 2024 at a single center.

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Pulmonary hypertension (PH) is a common complication of chronic respiratory diseases (CRD) associated with increased morbidity and mortality. Early and individualized identification of PH in these patients is crucial to better understand the evolution of the disease and to assess the application of therapeutic measures aimed at its control. However, there is no consensus on how to approach the diagnostic process.

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Although current guidelines recommend standard cardiopulmonary exercise testing (CPET) to evaluate symptomatic patients after pulmonary embolism (PE), CPET with simultaneous echocardiography could provide relevant information to evaluate right ventricular-pulmonary arterial coupling. The aim of this study was to investigate exercise-induced changes in echocardiographic variables of RV function or RV- arterial coupling in patients with residual thrombotic defects at 3 months after PE. This retrospective study investigated patients with residual thromboembolic disease on V/Q scintigraphy with persistent symptoms despite adequate anticoagulation after 3 months of acute PE, and resting echocardiography with a low probability of PH.

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Severe vitamin D (vitD) deficiency is a very common condition in patients with pulmonary arterial hypertension (PAH), and it is a predictor of poor prognosis. There is emerging evidence suggesting a connection between the insufficient response to phosphodiesterase-5 inhibitors (PDE5i) and vitD deficiency in patients with PAH. In the present translational study, vitD deficiency was induced in Wistar rats by exposure to vitD-free diet for 5 wk and followed by Su5416 administration and hypoxia (10%) for 3 wk, a standard experimental model of PAH.

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Pulmonary Embolism (PE) is a life-threatening condition initiated by the presence of blood clots in the pulmonary arteries, leading to severe morbidity and mortality. Underlying mechanisms involve endothelial dysfunction, including impaired blood flow regulation, a pro-thrombotic state, inflammation, heightened oxidative stress, and altered vascular remodeling. These mechanisms contribute to vascular diseases stemming from PE, such as recurrent thromboembolism, chronic thromboembolic pulmonary hypertension, post-thrombotic syndrome, right heart failure, and cardiogenic shock.

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Introduction: The clinical validity of real-world walking cadence in people with COPD is unsettled. Our objective was to assess the levels, variability and association with clinically relevant COPD characteristics and outcomes of real-world walking cadence.

Methods: We assessed walking cadence (steps per minute during walking bouts longer than 10 s) from 7 days' accelerometer data in 593 individuals with COPD from five European countries, and clinical and functional characteristics from validated questionnaires and standardised tests.

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Article Synopsis
  • Chronic thromboembolic pulmonary disease (CTEPD) includes ongoing pulmonary vascular blockages that can limit function, and this study aimed to assess how often these defects and chronic thromboembolic pulmonary hypertension (CTEPH) occur in COVID-19 patients after a pulmonary embolism (PE) within a two-year span.
  • A total of 133 hospitalized COVID-19 patients with PE were observed over two years, with assessments for residual thrombotic defects and their overall health, revealing that 18% had ongoing thrombotic issues and CTEPD incidence was low at 0.75%.
  • Key risk factors for persistent defects included older age, higher incidence of hypertension, elevated D-dimer and NT-proBN
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Introduction: Patients with chronic obstructive pulmonary disease (COPD) accumulate low levels of physical activity. How environmental factors affect their physical activity in the short-term is uncertain.

Aim: to assess the short-term effects of air pollution and weather on physical activity levels in COPD patients.

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Introduction: In stable patients with pulmonary arterial hypertension (PAH), pulmonary rehabilitation (PR) is an effective, safe and cost-effective non-pharmacological treatment. However, the effects of PR on vascular function have been poorly explored. This study aimed to compare the amounts of circulating progenitor cells (PCs) and endothelial microvesicles (EMVs) in patients with PAH before and after 8 weeks of endurance exercise training as markers of vascular competence.

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Purpose Of Review: Pulmonary hypertension (PH) is a common complication of both chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD), classified as Group 3 PH. To which extent PH presents and behaves similarly in COPD and ILD is unclear. This review examines the similarities and differences in pathogenesis, clinical presentation, natural history and treatment response of PH in COPD and ILD.

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Introduction: Chronic thromboembolic pulmonary hypertension (CTEPH) is a long-term sequel to pulmonary embolism (PE) whose incidence varies according to different published studies. We have carried out this study to determine its incidence within 2 years after index pulmonary embolism and to study limitations to an early diagnosis.

Material And Methods: OSIRIS is a multicentre, longitudinal cohort study.

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We hypothesized that a rise in the levels of oxidative/nitrosative stress markers and a decline in antioxidants might take place in systemic and muscle compartments of chronic obstructive pulmonary disease (COPD) patients with non-anemic iron deficiency. In COPD patients with/without iron depletion ( = 20/group), markers of oxidative/nitrosative stress and antioxidants were determined in blood and vastus lateralis (biopsies, muscle fiber phenotype). Iron metabolism, exercise, and limb muscle strength were assessed in all patients.

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We hypothesized that iron content and regulatory factors, which may be involved in exercise tolerance, are differentially expressed in systemic and muscle compartments in iron deficient severe chronic obstructive pulmonary disease (COPD) patients. In the vastus lateralis and blood of severe COPD patients with/without iron depletion, iron content and regulators, exercise capacity, and muscle function were evaluated in 40 severe COPD patients: non-iron deficiency (NID) and iron deficiency (ID) (20 patients/group). In ID compared to NID patients, exercise capacity, muscle iron and ferritin content, serum transferrin saturation, hepcidin-25, and hemojuvelin decreased, while serum transferrin and soluble transferrin receptor and muscle IRP-1 and IRP-2 increased.

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Article Synopsis
  • The study investigates how various factors, including muscle strength and symptoms of anxiety and depression, influence physical activity (PA) in patients with idiopathic pulmonary fibrosis (IPF) and their progression over 12 months.
  • It was found that lower muscle strength, fewer steps taken, and higher depression levels are linked to reduced daily physical activity.
  • Additionally, patients who decreased their activity over the year had a significantly lower survival rate compared to those who maintained or increased their activity levels.
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Background: Frequently used reference values for clinical exercise testing have been derived from non-random samples and some with poorly defined maximal criteria. Our objective was to obtain population based reference values for peak oxygen uptake (V?O) and work rate (WR) for cardiopulmonary exercise testing in a representative sample of Caucasian Spanish men and women.

Methods: 182 men and women, 20-85 years old, were included and exercised on cycle-ergometer to exhaustion.

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Article Synopsis
  • The study examines the impact of borderline pulmonary hypertension (BLPH) on survival rates in patients with chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD).
  • BLPH was found in 14% of patients; however, survival rates did not significantly differ when comparing hemodynamic severity across both diseases.
  • In the ILD group, any level of pulmonary hypertension correlated with worse survival, while in the COPD group, only patients with severe pulmonary hypertension showed a significantly reduced survival rate.
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Introduction: Iron deficiency affects exercise capacity because of the critical role iron plays in the optimal functioning of skeletal muscle metabolism. We hypothesized that intravenous iron may improve exercise tolerance, quality of life (QoL), and daily physical activity (DPA) in patients with chronic obstructive pulmonary disease (COPD).

Methods: This was a placebo-controlled, single-blind, parallel-group, randomized clinical trial.

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Background: Supplemental oxygen delivered with standard oxygen therapy (SOT) improves exercise capacity in patients with idiopathic pulmonary fibrosis (IPF). Although high-flow nasal cannula oxygen therapy (HFNC) improves oxygenation in other respiratory diseases, its impact on exercise performance has never been evaluated in IPF patients. We hypothesized that HFNC may improve exercise capacity in IPF subjects compared to SOT.

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Unlabelled: Pulmonary involvement in COVID-19 is frequently associated with alterations in oxygenation. The arterial partial pressure of oxygen (PaO) is the most clinically used variable to assess such oxygenation, since it decisively influences the oxygen transported by hemoglobin (expressed by its percentage of saturation, SaO). However, two recent studies conducted respectively and using omic techniques in red blood cells of COVID-19 patients have suggested that SARS-CoV-2 could decrease the affinity of oxygen for the hemoglobin (which would imply that PaO would overestimate SaO), and also reduce the amount of this carrier molecule.

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In COPD patients, non-anemic iron deficiency (NAID) is a common systemic manifestation. We hypothesized that in COPD patients with NAID, iron therapy may improve systemic oxidative stress. The FACE (Ferinject assessment in patients with COPD and iron deficiency to improve exercise tolerance) study was a single-blind, unicentric, parallel-group, placebo-controlled clinical trial (trial registry: 2016-001238-89).

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