[Combination drug therapy in pulmonary hypertension: switch from selexipaq to intravenous trepostinil].

A wide range of substances is currently available for the treatment of patients with pulmonary arterial hypertension. The current recommendations for initial drug therapy are based on the patient's risk profile. For patients at high risk, an initial triple combination therapy with different substances including prostanoids is recommended.

Association Between Sleep Position, Obesity, and Obstructive Sleep Apnea Severity.

Background: This study examines the relationship between obstructive sleep apnea severity, sleep position, and body weight, particularly focusing on the negative impact of sleeping in a supine position combined with being overweight in a population-based sample.

Methods: The Apnea-Hypopnea Index (AHI) was utilized as a marker of OSA severity and sleep position from a standardized overnight polysomnography. Participants were categorized by body mass index (BMI) (kg/m) into normal weight/underweight (<25) and overweight (≥25).

[Prolonged weaning after long-term ventilation due to SARS-CoV-2 infection: a multicenter retrospective analysis].

Unlabelled: Some of the patients with SARS-CoV-2 infection (COVID-19) received invasive ventilation during inpatient care. Weaning from ventilation was difficult for some patients (so-called prolonged weaning).

Patients: Patients (n=751) with prolonged weaning (reason for ventilation "pneumonia" and "acute respiratory failure") from four centers for the period 2011-23 from the "WeanNet" registry were used as a matched group.

Cardiopulmonary exercise testing and the 2022 definition of pulmonary hypertension.

Parameters of cardiopulmonary exercise testing significantly discriminate between healthy subjects and patients with pulmonary hypertension (PH), also according to the new 2022 definition of pulmonary hypertension (mean pulmonary arterial pressure mPAP > 20 mmHg). The cut-offs indicating on PH were peakVO ≤ 16.7 mL/min/kg (Youden-Index YI = 0.

Acute COPD exacerbation treatment with noninvasive ventilation.

The establishment of a guideline for long-term noninvasive ventilation treatment (LTH-NIV) of acute hypercapnic exacerbations of chronic obstructive pulmonary disease (AECOPD) requiring acute ventilation has proven elusive. Most studies thus far have shown no mortality benefit of long-term noninvasive ventilation treatment. Using retrospective analysis of the data of our patients (n = 143) recruited from 2012 to 2019, we aimed to compare patients discharged with and without long-term noninvasive ventilation.

Menopause Is Associated with Obstructive Sleep Apnea in a Population-Based Sample from Mecklenburg-Western Pomerania, Germany.

Menopause is associated with multiple health risks. In several studies, a higher incidence or a higher risk for obstructive sleep apnea (OSA) in post-menopausal than pre-menopausal women is reported. This study was designed to verify such a connection between menopause and OSA in a population-based sample.

Quality of life in patients with obstructive sleep apnea: Results from the study of health in Pomerania.

Obstructive sleep apnea is known to be an overall public health problem that, among other things, increases morbidity and mortality. Risk factors as well as symptoms of this multidimensional sleep-related breathing disorder negatively affect quality of life. With our study we aimed to expose the association between obstructive sleep apnea and quality of life in the population of Pomerania, Germany.

Comparison between thermodilution and Fick methods for resting and exercise-induced cardiac output measurement in patients with chronic dyspnea.

Studies comparing thermodilution (TD) and the direct Fick method (dFM) for cardiac output (CO) measurement are rare. We compared CO measurements between TD (2-5 cold water injections), the dFM, and indirect Fick method (iFM) at rest and during exercise, and assessed the effect of averaging different numbers of TD measurements during exercise. This retrospective study included 300 patients (52.

Correlation of Hemodynamic and Respiratory Parameters in Invasive Cardiopulmonary Exercise Testing (iCPET).

Background: Invasive cardiopulmonary exercise testing (iCPET) is an integral part in the advanced diagnostic workup of pulmonary hypertension (PH). Our study evaluated the relation between hemodynamic and respiratory parameters at two different resting conditions and two defined low exercise levels with a close synchronization of measurements in a broad variety of dyspnea patients. Subjects and methods: We included 146 patients (median age 69 years, range 22 to 85 years, n = 72 female) with dyspnea of uncertain origin.

Socioeconomic factors do not predict sleep apnea in a population sample from Mecklenburg-Western Pomerania, Germany.

Purpose: Socioeconomic factors are known to modulate health. Concerning sleep apnea, influences of income, education, work, and living in a partnership are established. However, results differ between national and ethnic groups.

[Risk Stratification in Patients with Pulmonary Arterial Hypertension under Treatment - Results of Four German Centers].

Risk stratification plays an essential role in the management of patients with pulmonary arterial hypertension (PAH). According to the current European guidelines the expected 1-year risk of mortality for PAH patients can be categorized as low, intermediate, or high, based on clinical, non-invasive and hemodynamic data.Data from 131 patients with incident PAH (age 64 ± 14) and frequent comorbidities (in 66.

Value of Cardiopulmonary Exercise Testing in the Prognosis Assessment of Chronic Obstructive Pulmonary Disease Patients: A Retrospective, Multicentre Cohort Study.

Introduction: Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases associated with high mortality. Previous studies suggested a prognostic role for peak oxygen uptake (VO2peak) assessed during cardiopulmonary exercise testing (CPET) in patients with COPD. However, most of these studies had small sample sizes or short follow-up periods, and despite their relevance, CPET parameters are not included in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) tool for assessment of severity.

Association Between Obstructive Sleep Apnea and Brain White Matter Hyperintensities in a Population-Based Cohort in Germany.

Importance: Underlying pathomechanisms of brain white matter hyperintensities (WMHs), commonly observed in older individuals and significantly associated with Alzheimer disease and brain aging, have not yet been fully elucidated. One potential contributing factor to WMH burden is chronic obstructive sleep apnea (OSA), a disorder highly prevalent in the general population with readily available treatment options.

Objective: To investigate potential associations between OSA and WMH burden.

Monotherapy in patients with pulmonary arterial hypertension at four German PH centres.

Background: Although combination therapy is the gold standard for patients with pulmonary arterial hypertension (PAH), some of these patients are still being treated with monotherapy.

Methods: We conducted a retrospective analysis at four German PH centres to describe the prevalence and characteristics of patients receiving monotherapy.

Results: We identified 131 incident PAH patients, with a mean age of 64 ± 13.

A 10-year follow-up of key gas exchange exercise parameters in a general population: results of the Study of Health in Pomerania.

Background: Cardiopulmonary exercise testing (CPET) is a frequently used method for the evaluation of the cardiorespiratory system. The prognostic relevance of the measured parameters is commonly known. Longitudinal data on cardiorespiratory fitness in a large sample of well-characterised healthy volunteers are rare in the literature.

Predictors of survival after prolonged weaning from mechanical ventilation.

Purpose: Weaning from mechanical ventilation is a key component of intensive care treatment; however, this process may be prolonged as some patients require care at specialised centres. Current data indicate that weaning from invasive mechanical ventilation is successful in approximately 65% of patients; however, data on long-term survival after discharge from a weaning centre are limited.

Materials And Methods: We analysed predictors of survival among 597 patients (392 men, mean age 68 ± 11) post-discharge from a specialised German weaning centre.

Exercise and fluid challenge during right heart catheterisation for evaluation of dyspnoea.

This prospective study compared exercise test and intravenous fluid challenge in a single right heart catheter procedure to detect latent diastolic heart failure in patients with echocardiographic heart failure with preserved ejection function. We included 49 patients (73% female) with heart failure with preserved ejection function and pulmonary artery wedge pressure ≤15 mmHg. A subgroup of 26 patients had precapillary pulmonary hypertension.

A Biased Diffusion Approach to Sleep Dynamics Reveals Neuronal Characteristics.

We propose a biased diffusion model of accumulated subthreshold voltage fluctuations in wake-promoting neurons to account for stochasticity in sleep dynamics and to explain the occurrence of brief arousals during sleep. Utilizing this model, we derive four neurophysiological parameters related to neuronal noise level, excitability threshold, deep-sleep threshold, and sleep inertia. We provide the first analytic expressions for these parameters, and we show that there is good agreement between empirical findings from sleep recordings and our model simulation results.

Interobserver variability of ventilatory anaerobic threshold in asymptomatic volunteers.

Background: The ventilatory anaerobic threshold (VO@AT) has been used in preoperative risk assessment and rehabilitation for many years. Our aim was to determine the interobserver variability of AT using cardiopulmonary exercise (CPET) data from a large epidemiological study (SHIP, Study of Health in Pomerania).

Methods: VO@AT was determined from CPET of 1,079 cross-sectional volunteers, according to American Heart Association guidelines.

Prevalence and association analysis of obstructive sleep apnea with gender and age differences - Results of SHIP-Trend.

Identification of obstructive sleep apnea and risk factors is important for reduction in symptoms and cardiovascular risk, and for improvement of quality of life. The population-based Study of Health in Pomerania investigated risk factors and clinical diseases in a general population of northeast Germany. Additional polysomnography was applied to measure sleep and respiration with the objective of assessing prevalence and risk factors of obstructive sleep apnea in a German cohort.