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BACKGROUND: Alterations in body composition, including a low fat-free mass index (FFMI), are common in patients with chronic obstructive pulmonary disease (COPD) and occur regardless of body weight. RESEARCH QUESTION: Is the impact of low FFMI on exercise capacity, health-related quality of life (HRQL) and systemic inflammation different among COPD patients stratified in different body mass index classifications? STUDY DESIGN AND METHODS: We analysed baseline data of COPD patients from the COSYCONET (COPD and Systemic Consequences - Comorbidities Network) cohort. Assessments included lung function, bioelectrical impedance analysis, six-minute walk distance (6MWD), HRQL and inflammatory markers. Patients were stratified in underweight (UW), normal weight (NW), pre-obese (PO) and obese (OB) according to BMI and as presenting low, normal or high FFMI using 25th and 75th percentiles of reference values. Linear mixed models were used to investigate the associations between FFM and fat mass with secondary outcomes in each BMI group. RESULTS: 2137 COPD patients (GOLD 1-4, 61% males, age: 65±8years, FEV1: 52.5±18.8%pred) were included. The proportions of patients in UW, NW, PO and OB groups were 12.3%, 31.3%, 39.6%, 16.8%. The frequency of low FFMI decreased from lower to higher BMI groups (UW:81%, NW:53%, PO:42%, OB:39%). FFM was associated with the 6MWD in the UW group, even when adjusting for a broad set of covariates (P0.32). Fat mass was associated with higher systemic inflammation in the NW and PO groups (P

PURPOSE: To investigate morphofunctional chest MRI for the detection and management of incidental pulmonary nodules in participants with chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS: In this prospective study, 567 participants (mean age, 66 years ± 9 [SD]; 340 men) underwent same-day contrast-enhanced MRI and nonenhanced low-dose CT (LDCT) in a nationwide multicenter trial (clinicaltrials.gov: NCT01245933). Nodule dimensions, morphologic features, and Lung Imaging Reporting and Data System (Lung-RADS) category were assessed at MRI by two blinded radiologists, and consensual LDCT results served as the reference standard. Comparisons were performed using the Student t test, and agreements were assessed using the Cohen weighted κ. RESULTS: A total of 525 nodules larger than 3 mm in diameter were detected at LDCT in 178 participants, with a mean diameter of 7.2 mm ± 6.1 (range, 3.1–63.1 mm). Nodules were not detected in the remaining 389 participants. Sensitivity and positive predictive values with MRI for readers 1 and 2, respectively, were 63.0% and 84.8% and 60.2% and 83.9% for solid nodules (n = 495), 17.6% and 75.0% and 17.6% and 60.0% for part-solid nodules (n = 17), and 7.7% and 100% and 7.7% and 50.0% for ground-glass nodules (n = 13). For nodules 6 mm or greater in diameter, sensitivity and positive predictive values were 73.3% and 92.2% for reader 1 and 71.4% and 93.2% for reader 2, respectively. Readers underestimated the long-axis diameter at MRI by 0.5 mm ± 1.7 (reader 1) and 0.5 mm ± 1.5 (reader 2) compared with LDCT (P < .001). For Lung-RADS categorization per nodule using MRI, there was substantial to perfect interreader agreement (κ = 0.75–1.00) and intermethod agreement compared with LDCT (κ = 0.70–1.00 and 0.69–1.00). CONCLUSION: In a multicenter setting, morphofunctional MRI showed moderate sensitivity for detection of incidental pulmonary nodules in participants with COPD but high agreement with LDCT for Lung-RADS classification of nodules. Clinical trial registration no. NCT01245933 and NCT02629432 Keywords: MRI, CT, Thorax, Lung, Chronic Obstructive Pulmonary Disease, Screening © RSNA, 2023 Supplemental material is available for this article.

Supplemental material, sj-pdf-1-tar-10.1177_17534666221148663 for Standardized airway wall thickness Pi10 from routine CT scans of COPD patients as imaging biomarker for disease severity, lung function decline, and mortality by Kathrin Kahnert, Rudolf A. Jörres, Hans-Ulrich Kauczor, Peter Alter, Franziska C. Trudzinski, Felix Herth, Bertram Jobst, Oliver Weinheimer, Sebastian Nauck, Pontus Mertsch, Diego Kauffmann-Guerrero, Jürgen Behr, Robert Bals, Henrik Watz, Klaus F. Rabe, Tobias Welte, Claus F. Vogelmeier and Jürgen Biederer in Therapeutic Advances in Respiratory Disease

Supplemental material, sj-docx-2-tar-10.1177_17534666221148663 for Standardized airway wall thickness Pi10 from routine CT scans of COPD patients as imaging biomarker for disease severity, lung function decline, and mortality by Kathrin Kahnert, Rudolf A. Jörres, Hans-Ulrich Kauczor, Peter Alter, Franziska C. Trudzinski, Felix Herth, Bertram Jobst, Oliver Weinheimer, Sebastian Nauck, Pontus Mertsch, Diego Kauffmann-Guerrero, Jürgen Behr, Robert Bals, Henrik Watz, Klaus F. Rabe, Tobias Welte, Claus F. Vogelmeier and Jürgen Biederer in Therapeutic Advances in Respiratory Disease

The primary goal of the study is to investigate dyspnea under different breathing conditions in patients with persistent dyspnea and/or fatigue after COVID-19 by using a rebreathing paradigm. We will investigate whether perceived dyspnea differs between patients with post-COVID symptoms and those who do not have persistent symptoms after COVID-19. Furthermore, we will examine whether there are differences in physiological breathing parameters such as breathing flow and CO2 concentration.

Alterations of cognitive functions have been described in COPD. Our study aimed to disentangle the relationship between the degree of cognitive function and COPD characteristics including quality of life (QoL).Data from 1969 COPD patients of the COSYCONET cohort (GOLD grades 1–4; 1216 male/ 753 female; mean (SD) age 64.9 ± 8.4 years) were analysed using regression and path analysis. The DemTect screening tool was used to measure cognitive function, and the St. George‘s respiratory questionnaire (SGRQ) to assess disease-specific QoL.DemTect scores were =60 years of age. For statistical reasons, we used the average of both algorithms independent of age in all subsequent analyses. The DemTect scores were associated with oxygen content, 6-min-walking distance (6-MWD), C-reactive protein (CRP), modified Medical Research Council dyspnoea scale (mMRC) and the SGRQ impact score. Conversely, the SGRQ impact score was independently associated with 6-MWD, FVC, mMRC and DemTect. These results were combined into a path analysis model to account for direct and indirect effects. The DemTect score had a small, but independent impact on QoL, irrespective of the inclusion of COPD-specific influencing factors or a diagnosis of cognitive impairment.We conclude that in patients with stable COPD lower oxygen content of blood as a measure of peripheral oxygen supply, lower exercise capacity in terms of 6-MWD, and higher CRP levels were associated with reduced cognitive capacity. Furthermore, a reduction in cognitive capacity was associated with reduced disease-specific quality of life. As a potential clinical implication of this work, we suggest to screen especially patients with low oxygen content and low 6-MWD for cognitive impairment.

Hohe Belastungen durch Beschleunigungskräfte beim Führen moderner Kampf-Jets wie des Eurofighter „Typhoon“ erfordern den Einsatz technischer Unterstützungssysteme, die u. a. durch Überdruckatmung des Piloten mit hohen Sauerstoffkonzentrationen dessen Leitungsfähigkeit erhalten. Mögliche Auswirkungen sowohl der G-Kräfte als solche als auch dieser Systeme auf die Lunge des Piloten bis hin zum Risiko von überdruckbedingten Lungenverletzungen wurden bisher nicht unter realen Flugbedingungen untersucht. Beim Zentrum für Luft- und Raumfahrtmedizin der Luftwaffe wurden im Rahmen einer Studie nichtinvasive Untersuchungsmethoden zur Erfassung möglicher Stressoren für die Atemwege im realen Flugbetrieb eines Eurofighter-Verbandes eingesetzt. Studiendesign, Messmethoden und ihre Bedeutung für die Messung vermuteter Atemwegsstressoren werden in dieser Arbeit vorgestellt.