Description:

Bronchopulmonary dysplasia (BPD) is the most frequent respiratory complication of extremely premature birth. In most studies, survivors of BPD have airflow limitation and their FEV1 does not reach the normally-expected optimal peak at 24 years old. Poor lung function early in life tracks with a weaker lung function in adulthood and a higher risk of a COPD-like disease.

• Learn to perform transbronchial lung cryobiopsy and how to insert this approach into the diagnostic workup of patients with suspected ILD.

Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic, progressive, fibrosing interstitial pneumonia of unknown cause. The disease is characterized by progressive morphologic changes of the lung architecture, causing cough and worsening dyspnea and, ultimately, leading to lung failure and death. It is defined by the histopathologic and/or high-resolution CT scan (HRCT) pattern of usual interstitial pneumonia (UIP). In all cases, exclusion of other known causes of lung fibrosis, in particular those linked to the environment, occupational exposures, drug toxicity, or systemic diseases, is required to establish the diagnosis of IPF. The disease is not readily recognized because of the lack of specific symptoms and, in general, for the poor awareness of the disease. On average, 2 years are necessary before receiving a correct diagnosis, often preceded by one or more misdiagnoses. Indeed, the diagnostic approach may be challenging, and a multidisciplinary approach, possibly in an expert center, is needed to obtain an accurate diagnosis.

Patients with COPD might present different clinical and inflammatory phenotypes. Therapeutic approach should take into consideration the heterogeneity of the disease and comorbidities that usually affect COPD patients. .

• Learn how a multidisciplinary approach can deal with the complexity of the disease.

• Explore how systemic and peripheral inflammation can impact on follow-up.

This session will cover the basics on the interpretation of hypoxia and hypoxemia, and the differences between these two conditions in terms of pathophysiological point of view. Two case reports will show the possible interpretation of lactatemia in blood gas analysis in patients with COVID-19.

Description:

Dyspnea and fatigue are cardinal symptoms of both cardiac and lung diseases. Frequently, these pathologies coexist, worsening clinical condition and making it difficult for physicians to correctly identify the cause of dyspnea and reduced exercise capacity. A wide amount of evidence suggests that CPET, in conjunction with PFT, is a useful clinical tool to identify cardiac and/or pulmonary causes of dyspnea of unclear or multifactorial origin. In fact, lung function evaluation is pivotal in the diagnostic assessment of heart failure, as lung disease comorbidities influence both prognosis and therapy. The close relationship between cardiac and pulmonary pathophysiology was first described in 1785 by Withering and in 1883 by Hope, who coined the term “cardiac asthma.” Moreover, several studies showed a reduction in FEV1, FVC and DLCO in heart failure. Several factors may be responsible for restrictive lung pattern in heart failure, such as increased lung stiffness due to alveolar effusion, reduction of working alveolar–capillary units, respiratory muscle fatigue, cardiac enlargement, and constriction of under-perfused alveoli leading to reduced lung compliance in a low cardiac output state. However, evidence in this field is not extensive and pathophysiology regulating heart-lung interactions is complex and not completely cleared.

• Mechanisms in heart failure that can induce a restrictive lung pattern

• Which variables of the CPET are important to evaluate a lung-restrictive pattern

• Clinical strategies in the treatment of lung/heart pathological interactions

Description:

This session will present the epidemiologic and clinical importance of atrial fibrillation, which is commonly associated with many other diseases, including diseases of the chest. The relationship between atrial fibrillation and stroke is clear, but the mechanism underlying this association appears nowadays more complex than in the past. Risk stratification for stroke is the basis for instituting oral anticoagulation, which has a major impact on the risk of stroke, with great value for the patients.