Summary Background Physical activity (PA) has been reported to be reduced in severe chronic obstructive pulmonary disease (COPD). Studies in moderate COPD are currently scarce. The aim of the present study was to investigate physical activity in daily life in patients with COPD (n = 70) and controls (n = 30). Methods A multi-center controlled study was conducted. PA was assessed using a multisensor armband device (SenseWear, BodyMedia, Pittsburgh, PA) and is reported as the average number of steps per day, and the time spent in mild and moderate physical activity. Results Patients suffered from mild (n = 9), moderate (n = 28), severe (n = 23) and very severe (n = 10) COPD. The time spent in activities with mild (80 ± 69 min vs 160 ± 89 min, p < 0.0001) and moderate intensity (24 ± 29 min vs 65 ± 70 min; p < 0.0036) was reduced in patients compared to controls. The number of steps reached 87 ± 34%, 71 ± 32%, 49 ± 34% and 29 ± 20% of control values in GOLD-stages I to IV respectively. The time spent in activities at moderate intensity was 53 ± 47%, 41 ± 45%, 31 ± 47% and 22 ± 34% of the values obtained in controls respectively with increasing GOLD-stage. These differences reached statistical significance as of GOLD stage II (p < 0.05). No differences were observed among centers. Conclusions Physical activity is reduced early in the disease progression (as of GOLD-stage II). Reductions in physical activities at moderate intensity seem to precede the reduction in the amount of physical activities at lower intensity.

This pilot study found that treatment with sildenafil reduced pulmonary vascular resistance and improved the BODE index and quality of life, without a significant effect on gas exchange.

The findings of this pilot study suggest that an extra-fine inhaled combination for the treatment of asthma has beneficial effects on both large and small airways function as expressed by Mch and sbN(2) tests.

<b><i>Background:</i></b> The impact of the new “borderline” hemodynamic class for pulmonary hypertension (PH) (mean pulmonary artery pressure [mPAP], 21–24 mm Hg and pulmonary vascular resistance, [PVR], ≥3 wood units, [WU]) in chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) is unclear. <b><i>Objectives:</i></b> The aim of this study was to assess the effect of borderline PH (BLPH) on survival in COPD and ILD patients. <b><i>Method:</i></b> Survival was analyzed from retrospective data from 317 patients in 12 centers (Italy, Spain, UK) comparing four hemodynamic groups: the absence of PH (NoPH; mPAP &#x3c;21 mm Hg or 21–24 mm Hg and PVR &#x3c;3 WU), BLPH (mPAP 21–24 mm Hg and PVR ≥3 WU), mild-moderate PH (MPH; mPAP 25–35 mm Hg and cardiac index [CI] ≥2 L/min/m²), and severe PH (SPH; mPAP ≥35 mm Hg or mPAP ≥25 mm Hg and CI &#x3c;2 L/min/m²). <b><i>Results:</i></b> BLPH affected 14% of patients; hemodynamic severity did not predict survival when COPD and ILD patients were analyzed together. However, survival in the ILD cohort for any PH level was worse than in NoPH (3-year survival: NoPH 58%, BLPH 32%, MPH 28%, SPH 33%, <i>p</i> = 0.002). In the COPD cohort, only SPH had reduced survival compared to the other groups (3-year survival: NoPH 82%, BLPH 86%, MPH 87%, SPH 57%, <i>p</i> = 0.005). The mortality risk correlated significantly with mPAP in ILD (hazard ratio [HR]: 2.776, 95% CI: 2.057–3.748, <i>p</i> &#x3c; 0.001) and notably less in COPD patients (HR: 1.015, 95% CI: 1.003–1.027, <i>p</i> = 0.0146). <b><i>Conclusions:</i></b> In ILD, any level of PH portends worse survival, while in COPD, only SPH presents a worse outcome.

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