Publications by authors named "David Montani"

Introduction: Progressive interstitial lung diseases (ILDs) are rare but severe diseases, with high mortality and morbidity, with no effective pharmacological treatment allowing for long-term remission, and therefore no clear therapeutic recommendations. Several ILDs present inflammatory components (ILDic), which may justify the use of anti-inflammatory and immunosuppressive drugs, as first-step therapy. Except for systemic sclerosis (SSc)-ILD and sarcoidosis, the evidence in favor of this approach is very weak.

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Background: Trastuzumab emtansine has been recently suspected to be associated with the development of pulmonary arterial hypertension (PAH).

Research Question: Is there an association between trastuzumab, trastuzumab emtansine, or trastuzumab deruxtecan and the development of PAH?.

Study Design And Methods: Characteristics of incident PAH cases treated with trastuzumab, trastuzumab emtansine, or trastuzumab deruxtecan were analyzed from the French PH Registry, the VIGIAPATH program, concurrently with a pharmacovigilance disproportionality analysis using the World Health Organization pharmacovigilance database using a broad definition of pulmonary hypertension (PH) and a narrow definition of PAH.

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Background: Pulmonary hypertension (PH) is an unusual complication of X-linked disease caused by loss-of-function (LOF) variants in the () gene. Patients with LOF may also present dysmorphic facial features, aortic dilation, thrombopenia, and periventricular nodular heterotopia (PVNH).

Methods: We reported clinical, functional, radiologic, and hemodynamic characteristics of patients with LOF variants and PH from the French PH Network.

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Article Synopsis
  • The study investigates whether pre-existing medical conditions increase the risk of developing major depressive episodes (MDE) after hospitalization for COVID-19.
  • It analyzed data from 650 patients six months post-hospitalization, focusing on conditions like high blood pressure, obesity, type 2 diabetes, and others.
  • Results showed that type 2 diabetes significantly raised the risk of new-onset MDE, prompting recommendations for screening in these patients after COVID-19 recovery.
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Pulmonary arterial hypertension (PAH) is a severe disease caused by progressive distal pulmonary artery obstruction. One cause of PAH are loss-of-function mutations in the potassium channel subfamily K member 3 (KCNK3). KCNK3 encodes a two-pore domain potassium channel, which is crucial for pulmonary circulation homeostasis.

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  • The effectiveness of oral anticoagulants in treating pulmonary arterial hypertension (PAH) is uncertain, with research showing mixed results regarding their safety and efficacy.
  • In contrast, oral anticoagulants are essential for managing chronic thromboembolic pulmonary hypertension (CTEPH) and are recommended to prevent recurring blood clots.
  • The selection of vitamin K antagonists versus direct oral anticoagulants involves weighing their pros and cons, especially considering drug interactions with other medications for PAH and CTEPH treatment.
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Pulmonary hypertension (PH) is a haemodynamic condition characterised by elevation of mean pulmonary arterial pressure (mPAP) >20 mmHg, assessed by right heart catheterisation. Pulmonary arterial wedge pressure (PAWP) and pulmonary vascular resistance (PVR) distinguish pre-capillary PH (PAWP ≤15 mmHg, PVR >2 Wood Units (WU)), isolated post-capillary PH (PAWP >15 mmHg, PVR ≤2 WU) and combined post- and pre-capillary PH (PAWP >15 mmHg, PVR >2 WU). Exercise PH is a haemodynamic condition describing a normal mPAP at rest with an abnormal increase of mPAP during exercise, defined as a mPAP/cardiac output slope >3 mmHg/L/min between rest and exercise.

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Background: Integrative multiomics can elucidate pulmonary arterial hypertension (PAH) pathobiology, but procuring human PAH lung samples is rare.

Methods: We leveraged transcriptomic profiling and deep phenotyping of the largest multicenter PAH lung biobank to date (96 disease and 52 control) by integration with clinicopathologic data, genome-wide association studies, Bayesian regulatory networks, single-cell transcriptomics, and pharmacotranscriptomics.

Results: We identified 2 potentially protective gene network modules associated with vascular cells, and we validated , coding for asporin, as a key hub gene that is upregulated as a compensatory response to counteract PAH.

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Introduction: Pulmonary arterial hypertension (PAH) is a rare and severe disease for which most of the evidence about prognostic factors, evolution and treatment efficacy comes from cohorts, registries and clinical trials. We therefore aimed to develop and validate a new PAH identification algorithm that can be used in the French healthcare database "Système National des Données de Santé (SNDS)".

Methods: We developed and validated the algorithm using the Grenoble Alpes University Hospital medical charts.

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Pulmonary arterial hypertension (PAH) is a chronic disorder characterized by excessive pulmonary vascular remodeling, leading to elevated pulmonary vascular resistance and right ventricle (RV) overload and failure. MicroRNA-146a (miR-146a) promotes vascular smooth muscle cell proliferation and vascular neointimal hyperplasia, both hallmarks of PAH. This study aimed to investigate the effects of miR-146a through pharmacological or genetic inhibition on experimental PAH and RV pressure overload animal models.

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Background: Exercise hemodynamics are recommended for early detection of pulmonary arterial hypertension (PAH) and have been suggested to be predictive of future development of PAH in high-risk populations such as BMPR2 mutation carriers. However, the optimal exercise hemodynamic screening parameter remains to be determined. Recent data suggest that pulmonary vascular distensibility (α) may serve as a useful parameter for early detection of PAH.

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Article Synopsis
  • Pathogenic variants in a specific gene significantly increase the risk of developing heritable pulmonary arterial hypertension, and examining unaffected carriers through advanced screening methods can help in early diagnosis and understanding of the condition.
  • A study compared 28 unaffected carriers to 21 healthy controls using various cardiac imaging and exercise tests; findings revealed carriers had smaller heart volumes but higher afterload, indicating potential early signs of the disease.
  • Over a 4-year follow-up, two unaffected carriers went on to develop pulmonary arterial hypertension, despite showing normal cardiac indices at the time of diagnosis, highlighting the importance of monitoring these individuals for early intervention.
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Background: The primary genetic risk factor for heritable pulmonary arterial hypertension is the presence of monoallelic mutations in the gene. The incomplete penetrance of mutations implies that additional triggers are necessary for pulmonary arterial hypertension occurrence. Pulmonary artery stenosis directly raises pulmonary artery pressure, and the redirection of blood flow to unobstructed arteries leads to endothelial dysfunction and vascular remodeling.

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  • Researchers surveyed 55 clinicians across Europe to understand how they manage pulmonary hypertension associated with interstitial lung disease (PH-ILD) and identify unmet needs since there are no approved therapies for this condition in Europe.
  • The study found that many clinicians rely on echocardiography and off-label treatments like PDE-5 inhibitors for PH-ILD patients, with 50% using off-label medications despite concerns about their efficacy.
  • The results indicate a significant gap in effective treatment options and emphasize the need for more clinical evidence to guide PH-ILD management.
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Pulmonary hypertension (PH) continues to present significant challenges to the medical community, both in terms of diagnosis and treatment. The advent of the updated 2022 European Society of Cardiology (ESC) and European Respiratory Society (ERS) guidelines has introduced pivotal changes that reflect the rapidly advancing understanding of this complex disease. These changes include a revised definition of PH, updates to the classification system, and treatment algorithm.

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  • Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are serious conditions requiring treatment to prevent progression and death; this study focuses on medication adherence (MA) and its impacts.
  • A systematic review analyzed 20 studies with over 22,000 patients, revealing MA levels varied widely, with factors like increased treatment frequency and co-payment linked to lower adherence rates.
  • High MA is associated with better clinical outcomes, fewer hospitalizations, and reduced healthcare costs, highlighting the need for educational efforts to improve adherence among patients.
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Excessive daytime sleepiness (EDS) is frequent among patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and can persist despite the optimal correction of respiratory events (apnea, hypopnea and respiratory efforts), using continuous positive airway pressure (CPAP) or mandibular advancement device. Symptoms like apathy and fatigue may be mistaken for EDS. In addition, EDS has multi-factorial origin, which makes its evaluation complex.

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Background And Objectives: Although many symptoms of post-COVID syndrome have been described, a comprehensive evaluation of their prevalence is lacking. We aimed to describe symptoms at 16 months from hospitalization for COVID-19.

Methods: A telephone assessment was performed one year later in a cohort of COVID-19 survivors hospitalized between March and May 2020 and already evaluated four months after discharge.

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Background: Despite its known cardiac and lung toxicities, the chemotherapy drug gemcitabine has only rarely been associated with pulmonary hypertension (PH), and the underlying mechanism remains unclear. The objective of the present study was to assess the association between gemcitabine and PH.

Methods: We identified incident cases of precapillary PH confirmed by right heart catheterisation in patients treated with gemcitabine from the French PH Registry between January 2007 and December 2022.

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Calcium (Ca) is a secondary messenger that regulates various cellular processes. However, Ca mishandling could lead to pathological conditions. Orai1 is a Cachannel contributing to the store-operated calcium entry (SOCE) and plays a critical role in Ca homeostasis in several cell types.

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