The Effect of Eccentric Cycling on Cerebral and Muscle Tissue Oxygenation in Patients with Pulmonary Hypertension and Healthy Individuals: A Randomized Controlled Crossover Trial.

: Eccentric cycling exercise (ECC) offers a low-metabolic-demand approach to exercise, potentially making it valuable for patients with pulmonary vascular disease (PVD). The aim of this study was to investigate how quadriceps and frontal cortex oxygenation, assessed by near-infrared spectroscopy (NIRS), differs during ECC compared to concentric cycling exercise (CON) in patients with PVD and in healthy individuals. : This randomized controlled crossover trial involved patients with PVD, defined as either pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH), and healthy volunteers.

Effect of Acetazolamide on Pulmonary Hemodynamics and Right Heart Function in Healthy Adults Going to Altitude: A Randomized Controlled Trial.

Background: Exposure to high altitude triggers hypoxic pulmonary vasoconstriction with a rise in pulmonary artery pressure (PAP). This may lead to symptomatic pulmonary hypertension with impaired right heart function and exercise capacity. We investigated whether preventive acetazolamide treatment would attenuate the altitude-induced PAP-increase and hereby improve hemodynamics in nonacclimatized middle-aged healthy lowland residents ascending to 3100 m.

Coronavirus infection and chronic lung allograft dysfunction: a retrospective cohort study.

Introduction: Long-term survival in lung transplant recipients is limited by chronic lung allograft dysfunction, which can be triggered by respiratory tract infections.

Study Aims: We investigated the incidence of chronic lung allograft dysfunction in a cohort of lung transplant recipients over 10 years, focusing on its association with human coronavirus (HCoV) respiratory tract infections and all-cause mortality.

Methods: This 10-year retrospective cohort included 259 lung transplant recipients between 2010 and 2020.

Reassessment of the Current Iron Deficiency Definition in Pulmonary Hypertension.

Iron deficiency (ID) is prevalent in pulmonary hypertension(PH), but there is no consensus on ID definition and its possible correlation to prognostic markers. Hence, in this study, PH-patients were recruited at the University Hospital Zurich from May 2019 to April 2021. Clinical and hemodynamic characteristics were recorded at inclusion and venous blood samples were taken.

Effect of moderate altitude and nocturnal oxygen therapy on cerebrovascular function in patients with COPD: A randomized, crossover trial at 2048 m.

We investigated whether nocturnal oxygen therapy improves next-day cerebrovascular function in lowlanders with chronic obstructive pulmonary disease (COPD) staying at moderate altitude. This randomized, placebo-controlled single-blind crossover trial was performed in moderate-to-severe COPD patients [forced expiratory volume in 1 s (FEV)/forced vital capacity (FVC) <0.7; FEV 30%-80% of predicted], living at <800 m a.

The Impact of Cardiac Output Methods on the Classification of Pulmonary Hypertension.

Cardiac output is essential to calculate pulmonary vascular resistance (PVR) and classify pulmonary hypertension (PH). Recent evidence has shown a lower agreement between thermodilution (COTD) and direct Fick (CODF) methods than historically estimated. The influence of the cardiac output measurement method on the classification of PH is poorly explored.

Morphology and ultrastructure of Tilioideae pollen: how to differentiate Craigia, Mortoniodendron, and Tilia.

Assigning fossil Tilioideae pollen grains to the extant genera Craigia, Mortoniodendron, and Tilia is difficult. Firstly, the pollen from these genera appears similar when studied only with light microscopy. Secondly, comparison data showing the morphological and ultrastructural range of Mortoniodendron pollen need to be better defined, and there is a lack of transmission electron micrographs of Craigia pollen.

Transbronchial cryobiopsy alone versus combined with traditional forceps biopsy for acute cellular rejection in lung transplant recipients. A diagnostic randomized trial.

Background: Transbronchial lung biopsy is routinely performed to identify acute cellular rejection (ACR) in lung transplant recipients (LTRs). This trial evaluates the clinical value of forceps and cryobiopsies versus cryobiopsies as a standalone diagnostic tool.

Methods: In this randomized trial, LTRs were randomly assigned to receive either 2 cryobiopsies (cryobiopsy group) or a combination of 5 forceps- and 2 cryobiopsies (combined group).

Exploring breath metabolomics as a non-invasive tool for detecting pulmonary vascular disease.

Aims: The aim of this initial study was to explore whether prediction models based on breath metabolome profiles could detect differences between pulmonary vascular disease (PVD) patients and healthy controls. Additionally, we sought to investigate the potential to distinguish between two major subtypes of PVD-pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH)-to support early detection and targeted treatment.

Methods And Results: We used real-time breath analysis to compare the breath profiles of patients with PVD to healthy controls, and the metabolome of patients with PAH to those with CTEPH.

Predictors of sleep-disordered breathing and chronic hypoventilation in obese women and men: a cross-sectional observational study.

Background And Aim: Obesity is associated with an increased risk of sleep-disordered breathing (SDB)-obstructive sleep apnoea (OSA) and sleep hypoventilation-and obesity hypoventilation syndrome (OHS). The aim was to assess the impact of obesity on lung volumes and the prevalence of SDB and OHS and to identify predictors of these.

Methods: In a cross-sectional analysis, obese patients (body mass index ≥30 kg/m) who underwent an in-laboratory sleep study, arterial blood gas analysis and pulmonary function tests between 2018 and 2023 were included.

Bicarbonate from arterial blood gas analysis as predictor of sleep-related hypoventilation: a diagnostic accuracy study.

Background: Bicarbonate above the upper limit of normal is used as an indicator of sleep-related hypoventilation in patients with diseases frequently associated with hypoventilation, such as obesity or neuromuscular diseases.

Research Question: The aim was to evaluate the diagnostic accuracy of bicarbonate from daytime arterial blood gas analysis for sleep-related hypoventilation measured via transcutaneous nocturnal capnometry.

Methods: In a diagnostic accuracy study, the sensitivity and specificity of bicarbonate concentration for detecting nocturnal hypoventilation were tested using a receiver operating curve (ROC) and logistic regression analysis in patients undergoing both an in-laboratory sleep study with transcutaneous capnometry and daytime arterial blood gas analysis.

Acute effect of acetazolamide on exercise haemodynamics in patients with pulmonary arterial and chronic thromboembolic pulmonary hypertension: a randomised controlled trial.

Background: The aim of this study was to investigate the acute effect of acetazolamide on pulmonary haemodynamics during exercise in patients with pulmonary vascular disease (PVD).

Methods: Patients with PVD diagnosed as pulmonary arterial (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) underwent right-heart catheterisation with haemodynamic measurements at rest and during stepwise incremental cycling exercise 60 min after receiving intravenous acetazolamide (500 mg) or saline placebo in accordance with a double-blind, randomised-controlled, crossover design. The main outcomes were the difference between pulmonary vascular resistance (PVR) and its components mean pulmonary artery pressure (mPAP), cardiac output (CO) and pulmonary arterial wedge pressure (PAWP), during exercise, assessed by a mixed linear regression analysis.

Pulmonary haemodynamics and right heart function during exercise at high versus low altitude in patients with pulmonary vascular disease: a randomised crossover trial.

Background: Patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension (PAH/CTEPH) may experience physiological stress at high altitude. We investigated pulmonary haemodynamics and right heart function during incremental (IET) and constant work-rate exercise tests (CWRET) at high (2500 m) vs low altitude (470 m).

Methods: In this randomised crossover trial, patients with stable PAH/CTEPH without resting hypoxaemia performed IET and CWRET at both altitudes.

Lipid Ratios for Diagnosis and Prognosis of Pulmonary Hypertension.

Pulmonary hypertension (PH) poses a significant health threat. Current biomarkers for PH lack specificity and have poor prognostic capabilities. To develop better biomarkers for PH that are useful for patient identification and management.

Effect of Eccentric Cycling on Oxygen Uptake and Hemodynamics in Patients with Chronic Obstructive Pulmonary Disease: A Randomized Controlled Crossover Trial.

Introduction: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide and contributes significantly to reduced quality of life due to symptoms such as dyspnea and exercise intolerance. Eccentric cycling exercise (ECC) has shown potential as an alternative to conventional concentric cycling exercise (CON) in cardiopulmonary disease, including COPD, as it has a lower metabolic demand and potentially allows for higher exercise intensity with less perceived exertion. We aimed to compare ventilatory and circulatory responses of COPD patients between ECC and CON at identical submaximal workloads.

Effects of CPAP on Blood Pressure Parameter Across Different Severities of Obstructive Sleep Apnoea: A Meta-Analysis.

In an unselected obstructive sleep apnoea (OSA) population, continuous positive airway pressure (CPAP) slightly lowers blood pressure (BP). The aim was to investigate the differential effects of CPAP on BP in different OSA severities. Medline was searched through December 2023 for randomised controlled trials (RCTs) on the effect of CPAP compared to an inactive control on office, 24 h, diurnal and nocturnal systolic and diastolic BP in OSA.

Oxygen saturation and acute mountain sickness during repeated altitude exposures simulating high-altitude working schedules.

This study aimed to quantify the effect of two consecutive prolonged, intermittent exposures to high and very high altitudes on oxygen saturation (SpO) and acute mountain sickness (AMS). For this, healthy lowlanders (N = 21), aged 18-30 years, underwent two 7-day sojourns at the ALMA observatory, Chile (6 h/day at 5050 m, 18 h/day at 2900 m), separated by 1-week at 520 m. SpO (pulse oximetry) and AMS severity (AMSc, Environmental Symptom Questionnaire cerebral score) diagnosing AMS (AMSc ≥ 0.

Monitoring sexual hormones in women going to high altitude-a pilot study.

Background: The susceptibility to acute mountain sickness (AMS) in relation to sexual hormones in women remains elusive, partly because hormones could not be conveniently measured. We evaluated a novel kit for self-monitoring sexual hormones in women and recorded AMS incidence during high-altitude sojourns.

Methods: Two groups of healthy, premenopausal women, mean ± SD age 23.

Medication adherence and clinical outcome in patients with pulmonary arterial hypertension or distal chronic thromboembolic pulmonary hypertension.

Introduction: In pulmonary arterial hypertension (PAH) and distal chronic thromboembolic pulmonary hypertension (CTEPH), the consistent use of disease-specific therapies is crucial. We aimed to investigate medication adherence to oral disease-specific medication and the impact on clinical outcome among patients with PAH or CTEPH to identify potential patient-related reasons for treatment incompliance.

Study Design And Methods: This prospective study focused on medication adherence using a multimeasure approach, including specialty pharmacy order data to calculate medication possession ratio (MPR) and self-reporting via questionnaire among patients with PAH or CTEPH.

Pulmonary haemodynamics by echocardiography over 3 days of acclimatization in lowlanders with chronic obstructive pulmonary disease travelling to 3100 m of high altitude.

Aims: Patients with chronic obstructive pulmonary disease experience an increase in systolic pulmonary artery pressure (sPAP) when exposed to high altitude with an unclear acclimatization. We investigated the effects of acute ascent to 3100 m on pulmonary haemodynamics of patients with chronic obstructive pulmonary disease and their acclimatization during a 3-day stay at high altitude.

Methods And Results: In this prospective, interventional study, stable, normocapnic patients with chronic obstructive pulmonary disease, with FEV 40-80%predicted and SpO ≥ 92%, residing at low altitude and staying for 3 days/nights at 3100 m without adverse events, were included.

Diagnosis of Peripheral Pulmonary Lesions Using Forceps and 1.1- or 1.7-mm Cryoprobes: A Randomised Trial.

Introduction: Lung cancer screening has increased the detection of peripheral pulmonary lesions (PPLs). Accurate diagnosis for therapy and prognosis is crucial but challenging. Our study compares the safety and efficacy of transbronchial cryobiopsy with two probe diameters and forceps biopsy.

Pulmonary Hypertension Associated with Interstitial Lung Disease: A Review on Diagnosis and Treatment with a Focus on Emerging Therapies.

Background: Pulmonary hypertension (PH) complicating interstitial lung diseases (ILDs) is critical for symptom burden and prognosis. The prevalence of PH varies according to ILD subgroups and severities. Establishing the diagnosis of PH associated with ILDs (PH-ILDs) is complex due to overlapping symptoms, late clinical signs, and poor diagnostic performance of routine noninvasive diagnostic methods.

Respiratory acclimatization and psychomotor performance after rapid ascent and during 3 weeks at 3,100 m-A prospective cohort study in healthy individuals.

Background: Acclimatization to high altitudes over several weeks has not been extensively studied. Repeated physiological assessments were performed in healthy lowlanders staying at 3,100 m for 3 weeks. We hypothesized that acute exposure to 3,100 m results in hypoxemia, sleep-disordered breathing, and postural instability, while a 3-week acclimatization at 3,100 m will improve these outcomes.

Effect of an Overnight Stay at 2,500 Meters on Nocturnal Hypoxemia and Sleep-disordered Breathing in Patients with Pulmonary Vascular Disease: A Randomized Clinical Trial.

Patients with pulmonary vascular disease often reveal nocturnal hypoxemia and sleep apnea. We investigated whether exposure to high altitude worsens those conditions. In a randomized controlled crossover trial, stable patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension without resting hypoxemia (arterial oxygen pressure, >8 kPa at low altitude) underwent respiratory polygraphy at 470 meters and during an overnight stay at 2,500 meters.

Impact of the establishment of a multidisciplinary national chronic thromboembolic pulmonary hypertension board on a monocentric surgical endarterectomy program.

Objectives: Chronic thromboembolic pulmonary hypertension is a rare disease, characterized by delays in diagnosis and curative surgical treatment. After establishing a surgical pulmonary endarterectomy centre in Switzerland and due to a historically low resection rate of 14%, a national multidisciplinary evaluation board was established in January 2018. Herein, we summarize the impact of the board on our programme.