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Respiratory Cardiology and Cardiopulmonary Rehabilitation: Insights into Cardiovascular and Pulmonary Interactions

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (25 January 2025) | Viewed by 3491

Special Issue Editors

Dr. Yoshitaka Iso

E-Mail Website
Guest Editor
Department of Internal Medicine, Division of Cardiology, Showa University Fujigaoka Hospital, Yokohama, Japan
Interests: heart failure; cardiac rehabilitation; cardiorespiratory physiology; cardio-oncolgy
Dr. Ssu-Yuan Chen

E-Mail Website
Guest Editor
1. Department of Physical Medicine & Rehabilitation, Fu Jen Catholic University Hospital and Fu Jen Catholic University School of Medicine, New Taipei City, Taiwan
2. Department of Physical Medicine & Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Interests: cardioplumonary rehabilitation; cardiopulmonary exercise testing; geriatric rehabilitation

Special Issue Information

Dear Colleagues,

The intricate interplay between the cardiovascular and pulmonary systems is increasingly gaining recognition. Pulmonary comorbidities are prevalent among heart failure patients, particularly in the elderly population. In recent years, significant advancements have been made in the detection and management of pulmonary vascular diseases. Mounting evidence supports the effectiveness of cardiac and pulmonary rehabilitation in improving the clinical outcomes and enhancing these patients’ quality of life.

In this Special Issue dedicated to cardiovascular diseases complicated by respiratory disorders, pulmonary vascular diseases, and cardiopulmonary physiology and rehabilitation, we are seeking original and review articles that (1) evaluate the implications of various advancements in this field, (2) underscore the unmet needs, and (3) explore future research directions. We also welcome case reports on this topic.

It is crucial for physicians to have a better understanding of various clinical settings and comorbidities. The Guest Editors anticipate that this will be of interest to cardiologists and a broad spectrum of clinicians who encounter cardiovascular diseases, especially those committed to addressing comorbidities.

Dr. Yoshitaka Iso
Dr. Ssu-Yuan Chen
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiovascular diseases
  • pulmonary circulation
  • cardiopulmonary rehabilitation
  • cardiopulmonary exercise testing
  • lung diseases
  • venous thromboembolism
  • cardio-oncology
  • sleep apnea

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Published Papers (3 papers)

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Research

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13 pages, 593 KiB  
Article
Ventilatory Response to Exercise in HFrEF-COPD: Importance of Exercise Modality
by Marta Íscar Urrutia, Julia Herrero Huertas, Marina Acebo Castro, Ramón Fernández Álvarez, Beatriz Díaz Molina and Marta García Clemente
J. Clin. Med. 2025, 14(8), 2538; https://doi.org/10.3390/jcm14082538 - 8 Apr 2025
Viewed by 235
Abstract
Background: Heart failure with reduced ejection fraction (HFrEF) frequently coexists with chronic obstructive pulmonary disease (COPD), and both conditions share symptoms such as exertional dyspnea. The cardiopulmonary exercise test (CPET) is an essential tool for assessing ventilatory and cardiovascular function and plays a [...] Read more.
Background: Heart failure with reduced ejection fraction (HFrEF) frequently coexists with chronic obstructive pulmonary disease (COPD), and both conditions share symptoms such as exertional dyspnea. The cardiopulmonary exercise test (CPET) is an essential tool for assessing ventilatory and cardiovascular function and plays a key role in the differential diagnosis of dyspnea. However, the impact of exercise modality on the ventilatory and cardiovascular parameters obtained remains unclear in these groups. Our aim is to compare the oxygen consumption (V·O2) and breathing reserve (BR) values obtained from CPET on a treadmill and a cycle ergometer in patients with HFrEF-COPD and those with HFrEF alone. Methods: A prospective observational study included 65 patients with HFrEF (LVEF ≤ 40%), 18 of whom had COPD. Two CPETs were performed, the first on a treadmill and the second 48–72 h later on a cycle ergometer. Results: In the group with HFrEF-COPD, peak oxygen consumption (VO2/kg) and maximum ventilation (VE) values were significantly higher on the treadmill (20 ± 5 vs. 17 ± 4 mL/kg/min, p < 0.001 and 55 ± 19 vs. 45 ± 11 L/min, p < 0.001, respectively), while breathing reserve (BR%) was lower on the treadmill (16 ± 21 vs. 33 ± 20, p < 0.001). Compared to the HFrEF group, patients with HFrEF-COPD had a lower BR in both exercise modalities (p = 0.01). Conclusions: Treadmill CPET demonstrates greater oxygen consumption and a more pronounced ventilatory response. BR is consolidated as a differential parameter in ventilatory limitation. The choice of exercise modality should be considered based on the underlying pathologies and the objective of the test. Full article
(This article belongs to the Special Issue Respiratory Cardiology and Cardiopulmonary Rehabilitation: Insights into Cardiovascular and Pulmonary Interactions)
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Review

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30 pages, 1605 KiB  
Review
A Practical Clinical Approach to Navigate Pulmonary Embolism Management: A Primer and Narrative Review of the Evolving Landscape
by Kevin Benavente, Bradley Fujiuchi, Hafeez Ul Hassan Virk, Pavan K. Kavali, Walter Ageno, Geoffrey D. Barnes, Marc Righini, Mahboob Alam, Rachel P. Rosovsky and Chayakrit Krittanawong
J. Clin. Med. 2024, 13(24), 7637; https://doi.org/10.3390/jcm13247637 - 15 Dec 2024
Viewed by 1687
Abstract
Advances in imaging, pharmacological, and procedural technologies have rapidly expanded the care of pulmonary embolism. Earlier, more accurate identification and quantification has enhanced risk stratification across the spectrum of the disease process, with a number of clinical tools available to prognosticate outcomes and [...] Read more.
Advances in imaging, pharmacological, and procedural technologies have rapidly expanded the care of pulmonary embolism. Earlier, more accurate identification and quantification has enhanced risk stratification across the spectrum of the disease process, with a number of clinical tools available to prognosticate outcomes and guide treatment. Direct oral anticoagulants have enabled a consistent and more convenient long-term therapeutic option, with a greater shift toward outpatient treatment for a select group of low-risk patients. The array of catheter-directed therapies now available has contributed to a more versatile and nuanced armamentarium of treatment options, including ultrasound-facilitated thrombolysis and mechanical thrombectomy. Research into supportive care for pulmonary embolism have explored the optimal use of vasopressors and volume resuscitation, as well as utilization of various devices, including right ventricular mechanical support and extracorporeal membrane oxygenation. Even in the realm of surgery, outcomes have steadily improved in experienced centers. This rapid expansion in diagnostic and therapeutic data has necessitated implementation of pulmonary embolism response teams to better interpret the available evidence, manage the utilization of advanced therapies, and coordinate multidisciplinary care. We provide a narrative review of the risk stratification and management of pulmonary embolism, with a focus on structuralizing the multidisciplinary approach and organizing the literature on new and emerging therapies. Full article
(This article belongs to the Special Issue Respiratory Cardiology and Cardiopulmonary Rehabilitation: Insights into Cardiovascular and Pulmonary Interactions)
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Other

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16 pages, 2723 KiB  
Systematic Review
Pulmonary Embolism Response Teams—Evidence of Benefits? A Systematic Review and Meta-Analysis
by Amelia Bryan, Quincy K. Tran, Jalil Ahari, Erin Mclaughlin, Kirsten Boone and Ali Pourmand
J. Clin. Med. 2024, 13(24), 7623; https://doi.org/10.3390/jcm13247623 - 14 Dec 2024
Viewed by 1028
Abstract
Background: Venous thromboembolisms constitute a major cause of morbidity and mortality with 60,000 to 100,000 deaths attributed to pulmonary embolism in the US annually. Both clinical presentations and treatment strategies can vary greatly, and the selection of an appropriate therapeutic strategy is often [...] Read more.
Background: Venous thromboembolisms constitute a major cause of morbidity and mortality with 60,000 to 100,000 deaths attributed to pulmonary embolism in the US annually. Both clinical presentations and treatment strategies can vary greatly, and the selection of an appropriate therapeutic strategy is often provider specific. A pulmonary embolism response team (PERT) offers a multidisciplinary approach to clinical decision making and the management of high-risk pulmonary emboli. There is insufficient data on the effect of PERT programs on clinical outcomes. Methods: We searched PubMed, Scopus, Web of Science, and Cochrane to identify PERT studies through March 2024. The primary outcome was all-cause mortality, and the secondary outcomes included the rates of surgical thrombectomy, catheter directed thrombolysis, hospital length of stay (HLOS), and ICU length of stay (ICULOS). We used the Newcastle−Ottawa Scale tool to assess studies’ quality. We used random-effects models to compare outcomes between the pooled populations and moderator analysis to identify sources of heterogeneity and perform subgroup analysis. Results: We included 13 observational studies, which comprised a total of 12,586 patients, 7512 (60%) patients were from the pre-PERT period and 5065 (40%) patients were from the PERT period. Twelve studies reported the rate of all-cause mortality for their patient population. Patients in the PERT period were associated with similar odds of all-cause mortality as patients in the pre-PERT period (OR: 1.52; 95% CI: 0.80–2.89; p = 0.20). In the random-effects meta-analysis, there was no significant difference in ICULOS between PERT and pre-PERT patients (difference in means: 0.08; 95% CI: −0.32 to 0.49; p = 0.68). There was no statistically significant difference in HLOS between the two groups (difference in means: −0.82; 95% CI: −2.86 to 1.23; p = 0.43). Conclusions: This meta-analysis demonstrates no significant difference in all studied measures in the pre- and post-PERT time periods, which notably included patient mortality and length of stay. Further study into the details of the PERT system at institutions reporting mortality benefits may reveal practice differences that explain the outcome discrepancy and could help optimize PERT implementation at other institutions. Full article
(This article belongs to the Special Issue Respiratory Cardiology and Cardiopulmonary Rehabilitation: Insights into Cardiovascular and Pulmonary Interactions)
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