Abstracts / 23rd Annual Congress

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Sep 11, 2013 - The publisher ensures that the text paper and cover board used have met acceptable environmental ...... Kahoku-gun, Ishikawa Prefecture, Japan ...... were found for other comorbidities (cardiac,etc), tobacco and alcohol. ...... explosive and endurance strength, and muscle mass was measured by DXA-scan.
VOLUME 42 / SUPPLEMENT 57 / SEPTEMBER 2013

Abstracts / 23rd Annual Congress Barcelona, Spain 7–11 September 2013

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CHIEF EDITOR Marc Humbert

Université Paris-Sud, Service de Pneumologie, Hôpital Bicêtre, 78 Rue de Général Leclerc, 94270 Le Kremlin-Bicêtre, France. E-mail: [email protected]

PUBLICATIONS OFFICE Managing Editor: Neil Bullen, [email protected] Head of Publications: Elin Reeves, [email protected] 442 Glossop Road, Sheffield, S10 2PX. Tel: +44 114 267 2860 | Fax: +44 114 266 5064

DEPUTY CHIEF EDITOR Anh Tuan Dinh-Xuan, Université Paris-Descartes, France.

ASSOCIATE EDITORS Nicolino Ambrosino, University Hospital of Pisa, Italy; Gary P. Anderson, University of Melbourne, Australia; Isabella Annesi-Maesano, Université Pierre et Marie Curie, France; Robert Bals, Universitätsklinikum des Saarlandes, Germany; Elisabeth H.D. Bel, University of Amsterdam, The Netherlands; Benjamin Besse, Institut GustaveRoussy, France; Louis-Philippe Boulet, Université Laval, Canada; Jean Bousquet, INSERM, France; Pascal Chanez, Université de la Méditerranée, France; Vincent Cottin, University of Lyon, France; Marion Delcroix, UZ Leuven, Belgium; Leonardo M. Fabbri, Università degli Studi di Modena e Reggio Emilia, Italy; Ramon Farré, Universitat de Barcelona, Spain; Mina Gaga, Athens Chest Hospital ‘Sotiria’, Greece; Dominik Hartl, University of Tübingen, Germany; Paul Hassoun, Johns Hopkins University School of Medicine, USA; Marius M. Hoeper, Hannover Medical School, Germany; Steven Kawut, University of Pennsylvania School of Medicine, USA; Melanie Koenigshof, Ludwig Maximilians University München, Germany; Stavros Konstantinides, Johannes Gutenberg University of Mainz, Germany; Tom Kotsimbos, Monash University, Australia; Claudia Kuehni, University of Bern, Switzerland; Patrick Lévy, Université Joseph Fourier, France; Joseph P. Lynch, University of California Los Angeles, USA; Peter J.F.M. Merkus, Radboud University Nijmegen Medical Centre, The Netherlands; Giovanni Battista Migliori, Fondazione S. Maugeri Care and Research Institute, Italy; Martin R. Miller, University of Birmingham, UK; Joachim Müller-Quernheim, Medizinische Klinik der Universität Freiburg, Germany; Robert Naeije, Erasme University Hospital, Belgium; Paolo Palange, Sapienza University of Rome, Italy; Ganesh Raghu, University of Washington Medical Center, USA; Luca Richeldi, University of Southampton, UK; Marina Saetta, Università degli Studi di Padova, Italy; Jean-Paul Sculier, Institut Jules Bordet, Belgium; Thomas Similowski, Université Pierre et Marie Curie, France; Joan B. Soriano, Recinte Hospital Joan March, Spain; Giovanni Sotgiu, University of Sassari, Italy; Rogerio Souza, University of Sao Paulo Medical School, Brazil; Paul E. Van Schil, University Hospital of Antwerp, Belgium; Norbert Voelkel, Virginia Commonwealth University, USA; Anton Vonk Noordegraaf, VU University Medical Center, The Netherlands; Wisia Wedzicha, University College London Medical School, UK; Tobias Welte, Hannover Medical School, Germany; Mark A. Woodhead, Manchester Royal Infirmary, UK.

INTERNATIONAL ADVISORY BOARD Peter J. Barnes, Imperial College London, UK; Eric Berglund, Gothenburg, Sweden; Judith L. Black, University of Sydney, Australia; Eric D. Bateman, University of Cape Town, South Africa; Francesco Blasi, Universita di Milano, Italy; Laurent Brochard, Hopitaux Universitaires de Geneve, Switzerland; Guy Brusselle, Ghent University Hospital, Belgium; Peter M.A. Calverley, University Hospital Aintree, UK; Ulrich Costabel, Ruhrlandklinik, Germany; Bruno Crestani, Université ParisDiderot, France; Jeffrey M. Drazen, Harvard University, USA; Ratko Djukanovic, University of Southampton, UK; Stephen Durham, Imperial College London, UK; Oliver Eickelberg, Helmholtz Zentrum München, Germany; Jorrit Gerritsen, University Medical Center Groningen, The Netherlands; Loïc Guillevin, Université ParisDescartes, France; Pieter Hiemstra, Leiden University Medical Center, The Netherlands; Nick Hill, Tufts New England Medical Center, USA; Stephen Holgate, University of Southampton, UK; Talmadge E. King Jr, University of California San Francisco, USA; Meinhard Kneussl, Wilhelminenspital, Medical University of Vienna, Austria; Bart Lambrecht, University of Ghent,  Belgium; Jim Loyd, Vanderbilt University, USA; Fernando J. Martinez, University of Michigan, USA; Benoit Nemery, Catholic University Leuven, Belgium; Laurent Nicod, Centre Hospitalier Universitaire Vaudois, Switzerland; Paul O’Byrne, McMaster University, Canada; Michael I. Polkey, Royal Brompton Hospital, UK; Klaus F. Rabe, Krankenhaus Großhansdorf, Germany; Marlene Rabinovitch, Stanford University, USA; Lewis J. Rubin, University of California San Diego, USA; Werner Seeger, University of Giessen, Germany; Nikolaos M. Siafakas, University of Crete, Greece; Yves Sibille, Université Catholique de Louvain, Belgium; Anita K. Simonds, Royal Brompton Hospital, UK; Gérald Simonneau, Université Paris-Sud, France; Peter D. Sly, University of Queensland, Australia; Peter J. Sterk, University of Amsterdam, The Netherlands; Samy Suissa, McGill University, Canada.

EDITORIAL BOARD MEMBERS Fekri Abroug, CHU F. Bourguiba, Tunisia; Ibrahim Abubakar, Health Protection Agency, UK; Ian Adcock, Imperial College London, UK; Yochai Adir, University of Haifa, Israel; Eric Austin, Vanderbilt University, USA; Claus Bachert, University of Ghent, Belgium; Joan Barbera, University of Barcelona, Spain; Neil C. Barnes, London Chest Hospital, UK; Richard Beasley, Medical Research Institute of New Zealand, New Zealand; Raymond L. Benza, Allegheny General Hospital, USA; Harm Jan Bogaard, VU University Medical Center, The Netherlands; Pierre-Yves Brillet, Université Paris-Nord, France; Pierre-Régis Burgel, Université Paris-Descartes, France; Carlos Camargo, Massachusetts General Hospital, USA; Jorge Cáneva, Fundacion Favaloro, Argentina; Giuseppe Cardillo, Azienda Ospedaliera San Camillo Forlanini, Italy; Thomas Casale, Creighton University School of Medicine, USA; Dan Chambers, University of Queensland, Australia; Daniela Maria Cirillo, San Raffaele Scientific Institute, Italy; Enrico M. Clini, Universitá degli Studi di Modena e Reggio Emilia, Italy; Hal Collard, University of California San Francisco, USA; Alvaro Cruz, Faculdade de Medicina da Bahia, Brazil; Sven-Erik Dahlen, Karolinska Institute, Sweden; Paul De Leyn, UZ Leuven, Belgium; Frances de Man, VU University Medical Center, The Netherlands; Laurence Dewachter, Free University of Brussels, Belgium; Roland Diel, Hannover Medical School, Germany; Gavin C. Donaldson, University College London, UK; Peter Dorfmüller, Université Paris-Sud, France; Sy Duong Quy, University of Dalat, Vietnam; Elie Fadel, Université Paris-Sud, France; Harrison W. Farber, Boston University, USA; Sean Gaine, University of Dublin, Ireland; Nazzareno Galiè, University of Bologna, Italy; Ardeshir Ghofrani, University of Giessen, Germany; Adam Giangreco, University College London, UK; Mardi Gomberg-Maitland, University of Chicago, USA; Marie Jose Goumans, Leiden Medical Center, The Netherlands; Bogdan Grigoriu, University of Medicine and Pharmacy Iasi, Romania; Christophe Guignabert, Université Paris-Sud, France; Francois Haddad, Stanford University, USA; Hamida Hammad, University of Ghent, Belgium; Agnès Hamzaoui, Hôpital Abderrahmen Mami, Tunisia; Sergio Harari, Ospedale San Giuseppe, Italy; Craig Hersh, Harvard University, USA; Carlos Jardim, University of Sao Paulo, Brazil; Zhi Cheng Jing, Shanghai Pulmonary Hospital,Tongji University, China; Adrien Kettaneh, Université Pierre et Marie Curie, France; Martin Kolb, McMaster University, Canada; Irene Lang, University of Vienna, Austria; Mareike Lankeit, Georg-August University of Goettingen, Germany; Philipp Latzin, University of Bern, Switzerland; Pierantonio Laveneziana, Université Pierre et Marie Curie, France; Wei Shen Lim, Nottingham City Hospital, UK; Jane Lucas, University of Southampton, UK; Antoine Magnan, Université de Nantes, France; Toby Maher, Imperial College London, UK; Marcus Mall, University of Heidelberg, Germany; Tom Marrie, Dalhousie University, Canada; Pierre Massion, Vanderbilt University, USA; Stephen C. Mathai, Johns Hopkins University School of Medicine, USA; Thais Mauad, Universidade de São Paulo, Brazil; Vallerie McLaughlin, University of Michigan, USA; Rosario Menéndez Villanueva, Universitary Hospital La Fe, Spain; David Montani, Université Paris-Sud, France; Luc Mouthon, Université Paris-Descartes, France; Matt Naughton, Monash University, Australia; J. Alberto Neder, Queen’s University, Canada; Mark R. Nicolls, Stanford University, USA; Dermot O’Callaghan, University College Dublin, Ireland; Neil Pearce, London School of Hygiene and Tropical Medicine, UK; Frédéric Perros, Université Paris-Sud, France; Charles Pilette, Cliniques Universitaires St-Luc, Belgium; Vsevolod Y. Polotsky, Johns Hopkins University School of Medicine, USA; Ioana Preston, Tufts Medical Center, USA; Steeve Provencher, Université Laval, Canada; Tomas Pulido, La Salle University, Mexico; Helen K. Reddel, Woolcock Institute of Medical Research, Australia; Bruce K. Rubin, Virginia Commonwealth University School of Medicine, USA; Dermot Ryan, University of Edinburgh, UK; Bernd Schmeck, Marburg University, Germany; Terry Seemungal, University of West Indies, Trinidad and Tobago; Ashok Shah, University of Delhi, India; Torben Sigsgaard, University of Aarhus, Denmark; Olivier Sitbon, Université Paris-Sud, France; Donald D. Sin, St. Paul’s Hospital, Canada; Stephen J. Till, King’s College, UK; Adam Torbicki, ECZ-Otwock, Poland; Dominique Valeyre, Université Paris-Nord, France; Marieke J. Van der Werf, European Centre for Disease Prevention and Control, Sweden; Grant Waterer, University of Western Australia, Australia; Kenneth Whythe, University of Auckland, New Zealand; John Wilson, Monash University, Australia; Paul Wolters, University of California San Francisco, USA; Pan-Chyr Yang, National Taiwan University College of Medicine, Taiwan; Spyros Zakynthinos, University of Athens, Greece; Jean-Pierre Zellweger, Swiss Lung Association, Switzerland. Past Chief Editors: J-C. Yernault†, Brussels, Belgium; E. Berglund, Gothenburg, Sweden; P. Vermeire†, Antwerp, Belgium; U. Costabel, Essen, Germany; M. Decramer, Leuven, Belgium; P.J. Sterk and K.F. Rabe, Amsterdam, the Netherlands and Kiel, Germany; A.T. Dinh-Xuan and V. Brusasco, Paris, France and Genoa, Italy.

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BARCELONA

ORGANISATION OF THE 23RD ERS ANNUAL CONGRESS

CONGRESS SECRETARIAT Joaquim Gea (Congress Chair) Servei Pneumologia – URMAR Hospital del Mar - IMIM – UPF Passeig Maritim 25-29 ES-08003 Barcelona, Spain Tel: + 34 932483138 [email protected]

Judith Garcia Aymerich (Congress Co-Chair) Centre for Research in Environmental Epidemiology Institut Municipal d’Investigacio Medica c/Doctor Aiguader 88 ES-08003 Barcelona, Spain Tel: + 34 932147350 [email protected]

Stephen Holgate (Scientific Committee Chair) Air Division, School of Medecine Mailpoint 810, Level F – South Block Southampton General Hospital Southampton, SO16 6YD, United Kingdom Tel: +44 2380796960 [email protected]

Laurent Pierre Nicod (Programme Committee Chair) Service de Pneumologie Centre Hospitalier Universitaire Vaudois Rue du Bugnon 46 CH-1011 Lausanne, Switzerland Tel: +41 213141380 Fax: +41 213141384 [email protected]

COMMITTEES Barcelona Congress Committee J. Gea, ES (Congress Chair) J. Garcia Aymerich, ES (Congress Co-Chair) F. Blasi, IT (President) M. Gaga, GR (Secretary General) G. Joos, BE (Treasurer) O. Eickelberg, DE (Congress Chair 2014) J. Behr, DE (Congress Co-Chair 2014) S. Holgate, UK (Scientific Committee Chair) A. Simonds, UK (School Chair) Barcelona Programme Committee L.P. Nicod, CH (Programme Committee Chair) J. Gea, ES (Congress Chair) J. Garcia Aymerich, ES (Congress Co-Chair) and Heads of Scientific Assemblies Heads of Scientific Assemblies A. Boehler, CH E. Clini, IT W. De Backer, BE E. Eber, AT T. Geiser, CH I. Horvath, HU C. Lange, DE B. Lundback, SE A-P. Meert, BE P. Pelosi, IT T. Troosters, BE ERS Executive Committee F. Blasi, IT (President) K.F. Rabe, DE (Past President) P. Barnes, UK (President-Elect) E. Bel, NL (Vice President) M. Gaga, GR (Secretary General) G. Joos, BE (Treasurer) S. Holgate, UK (Scientific Committee Chair) A. Simonds, UK (School Chair) W. Wedzicha, UK (Publications Committee Chair) J-P. Sculier, BE (Secretary for EU Affairs) M. Fletcher, UK (ELF Chair) and Heads of Scientific Assemblies Observers on the Executive Committee G.B. Migliori, IT (Secretary General-Elect) M. Elliott, UK (Treasurer-Elect) General organisation ERS Headquarters 4, Ave Sainte-Luce CH–1003 Lausanne, Switzerland Tel: +41 212130101 | Fax: +41 212130100 [email protected] | www.ersnet.org For any queries on abstracts: [email protected]

Copyright © ERS 2013 European Respiratory Journal ISSN 0903-1936

Annual Congress

BARCELONA September 7 ̶ 11, 2013

2013

ABSTRACTS

Contents Sunday, September 8th 2013 172 - 179 180 - 187 188 - 195 196 - 203 204 - 211 212 - 219 220 - 227 P228 - P243 P244 - P261 P262 - P279 P280 - P288 P289 - P306 P307 - P324 354 - 361 362 - 368 369 - 376 377 - 384 385 - 391 392 - 399 400 - 407 P408 - P425 P426 - P443 P444 - P461 P462 - P479 P480 - P497 P498 - P515 P516 - P533 P534 - P553 P554 - P573 P574 - P592 P593 - P612 P613 - P632 P633 - P649 P650 - P669 P670 - P689 P690 - P708 P709 - P728 P729 - P748 P749 - P767 P768 - P787 P788 - P806 P807 - P826 P827 - P846 P847 - P866 P867 - P886 P887 - P906 P907 - P926 P927 - P946 P947 - P966 P967 - P986

40. Guidelines and exacerbations .................................................................................................. 1s 41. New bronchodilators for COPD management.........................................................................3s 42. Drug-resistant tuberculosis: new clinical and public health insights ......................................5s 43. Lung surgery: preoperative assessment and postoperative outcome.......................................7s 44. Functional imaging of the lung, airways and diaphragm ........................................................9s 45. The kaleidoscope of respiratory nursing ...............................................................................12s 46. Cutting edge: drug delivery to the airways ...........................................................................14s 47. Structural and functional imaging discussion: sometimes different but always linked ........16s 48. Translational studies in chronic lung diseases: from bedside to bench .................................21s 49. Quality of diagnosis and assessment in primary care............................................................25s 50. Health economics of airway diseases ....................................................................................29s 51. Pneumonia and sepsis............................................................................................................32s 52. Heart, blood and metabolism in sleep disordered breathing .................................................37s 60. Is it really asthma?.................................................................................................................41s 61. New insights into mechanisms of lung allograft dysfunction ...............................................43s 62. Advances in the therapy of lung cancer.................................................................................45s 63. Pulmonary infection in children: diagnosis and long-term effects........................................47s 64. Experimental models in critical care .....................................................................................49s 65. Biomarkers in asthma and COPD .........................................................................................51s 66. From air pollution during pregnancy to respiratory diseases at work ...................................53s 67. Novel biomarkers and old parameters in clinical management of lung diseases ..................55s 68. TBNA, EBUS-TBNA and new technologies for diagnostic bronchoscopy ..........................59s 69. Oncological thoracic surgery.................................................................................................63s 70. Idiopathic pulmonary fibrosis and rarities .............................................................................68s 71. Pulmonary circulation: animal models and experimental treatments ...................................73s 72. Tuberculosis diagnosis ..........................................................................................................77s 73. Novel in vitro and animal models to study lung diseases .....................................................82s 74. Translational research to bridge the need within clinical decision making...........................86s 75. Airway smooth muscle and cell biology ...............................................................................91s 76. Asthma: new mechanisms and markers.................................................................................96s 77. COPD: new markers of diseases .........................................................................................101s 78. COPD: experimental biology ..............................................................................................105s 79. The vulnerable patient and ageing cells .............................................................................. 111s 80. Novel mechanisms in lung injury........................................................................................115s 81. Preclinical models for the development of new drugs for respiratory diseases ..................120s 82. Asthma and COPD drugs: efficacy, safety and pharmacoeconomics ..................................125s 83. Novel pharmacological findings in the management of respiratory disorders ....................131s 84. Novel drugs and biomarkers in respiratory medicine .........................................................136s 85. Clinical trials of LAMAs, LABAs, MABAs and theophylline for asthma and COPD ......141s 86. Predictors and triggers of asthma and COPD exacerbations...............................................147s 87. Monitoring lung function in airway diseases ......................................................................152s 88. Disease control and quality of life in airway diseases.........................................................157s 89. Systemic and airway biomarkers in respiratory diseases ....................................................161s 90. Asthma .................................................................................................................................167s 91. Cell biology and murine models of asthma and inflammation............................................172s 92. Genetics and mechanisms of, and tests for, allergy.............................................................176s 93. Treatment of asthma ............................................................................................................181s 94. Assessing the prevalence of COPD in the general population ............................................186s 95. Treatment and adherence to treatment of respiratory disease .............................................191s 96. Epidemiology of asthma......................................................................................................196s v

Contents

P987 - P1006 P1007 - P1026 P1027 - P1046 P1047 - P1066 P1067 - P1085 P1086 - P1105 P1106 - P1125 P1126 - P1144 P1145 - P1164 P1165 - P1181 P1182 - P1200 P1201 - P1220 P1221 - P1239 P1240 - P1256 P1257 - P1275 P1276 - P1294 P1295 - P1314 P1315 - P1334 P1335 - P1354 P1355 - P1374 P1375 - P1391 P1392 - P1409 1474 - 1481 1482 - 1489 1490 - 1496 1497 - 1504 1505 - 1512 1513 - 1519 1520 - 1527 P1528 - P1545 P1546 - P1563 P1564 - P1581 P1582 - P1599 P1600 - P1617 P1618 - P1634

97. Occupational respiratory diseases: obstructive, interstitial lung diseases and methods of diagnosis .........................................................................................................201s 98. Outdoor and indoor environment: respiratory diseases from asthma to asbestosis ............206s 99. World tour of tobacco epidemiology ...................................................................................211s 100. E-cigarettes, shisha, the tobacco industry and public health .............................................215s 101. Passive smoking, children and students (young adults) ....................................................220s 102. Clinical applications of respiratory physiology in children ..............................................225s 103. Monitoring asthma: genes, cells and molecules ................................................................229s 104. Uncontrolled and severe asthma in children .....................................................................235s 105. Preschool wheeze ..............................................................................................................239s 106. Cystic fibrosis: clinical problems and microbiology in adults ..........................................243s 107. Cystic fibrosis: clinical problems, genetics and microbiology in children........................247s 108. The burden of respiratory infections in children ...............................................................252s 109. Paediatric respiratory epidemiology: new understandings of lung function, disorders of prematurity and chronic airway diseases .......................................................256s 110. Paediatric bronchology ......................................................................................................261s 111. Expiration, exhalation and exhaustion: measures of dynamic volumes, breath analysis and respiratory muscles .......................................................................................265s 112. Airway calibre, airway challenge and assessment of oxygenation....................................270s 113. Exercise, physiotherapy techniques and assessment methods in COPD and asthma........274s 114. Exercise and physiotherapy in non-COPD conditions and in the assessment of healthy subjects .............................................................................................................279s 115. Assessment methods involved in the physiotherapy treatment in different patient populations .............................................................................................................284s 116. Aspects of physiotherapy in various clinical conditions and settings ...............................289s 117. Respiratory nursing care: assessment, interventions and education ..................................293s 118. Genetics and genomics of lung disease .............................................................................297s 144. New insights in the assessment of physical activity in daily life in patients with COPD, asthmatics and smokers .........................................................................................302s 145. New perspectives of lung function assessment in children ...............................................304s 146. Viral infections: what is new? ...........................................................................................306s 147. Pulmonary circulation: basic science ................................................................................308s 148. New strategies in epigenomic research to study lung diseases (DNA rearrangements, RNA, methylation, proteosome) .............................................................310s 149. Fundamental biology of malignant pleural effusions ........................................................312s 150. Genetic factors in airway development and disease..........................................................313s 151. COPD diagnosis ................................................................................................................316s 152. Environment and lifestyle: associations with respiratory disease .....................................320s 153. Murine models of lung immunology .................................................................................325s 154. New drugs in respiratory medicine ...................................................................................329s 155. Tuberculosis and latent tuberculosis infection in subpopulations .....................................334s 156. Asthma, allergy and lung function: natural history and risk factors in longitudinal studies ................................................................................................................................338s

Monday, September 9th 2013 1759 - 1766 1779 - 1786 1787 - 1794 1795 - 1802 1803 - 1810 1812 - 1818 1819 - 1826 P1827 - P1844 P1845 - P1859 P1860 - P1877 P1878 - P1895

196. Novel drugs for the treatment of asthma and COPD.........................................................343s 200. Pulmonary circulation: treatment ......................................................................................344s 201. Reference, reliability and risk: advances in lung function ................................................347s 202. Clinical management of orphan lung diseases ..................................................................350s 203. Highlights in epidemiology of respiratory disease ............................................................352s 204. Acute lung injury: novel clinical and experimental insights .............................................354s 205. Epidemiology, screening and diagnosis of lung cancer ....................................................356s 206. The best posters in exercise testing and physical inactivity ..............................................358s 207. Improving educational programmes for patients and multidisciplinary healthcare professionals ......................................................................................................................363s 208. COPD: acute exacerbations and others .............................................................................367s 209. Viral infections ..................................................................................................................371s vi

Contents

P1896 - P1912 P1913 - P1930 1965 - 1972 1973 - 1980 1981 - 1988 1989 - 1996 1997 - 2003 2004 - 2011 P2012 - P2029 P2030 - P2047 P2048 - P2063 P2064 - P2081 P2082 - P2099 P2100 - P2117 P2118 - P2137 P2138 - P2156 P2157 - P2176 P2177 - P2196 P2197 - P2213 P2214 - P2233 P2234 - P2253 P2254 - P2266 P2267 - P2279 P2280 - P2299 P2300 - P2319 P2320 - P2339 P2340 - P2359 P2360 - P2379 P2380 - P2398 P2399 - P2418 P2419 - P2438 P2439 - P2457 P2458 - P2477 P2478 - P2495 P2496 - P2515 P2516 - P2535 P2536 - P2555 P2556 - P2575 P2576 - P2595 P2596 - P2615 P2616 - P2635 P2636 - P2655 P2656 - P2670 P2671 - P2690 P2691 - P2710 P2711 - P2730 P2731 - P2750 P2751 - P2770 P2771 - P2790 P2791 - P2809 P2810 - P2828 P2829 - P2848 P2849 - P2868 P2869 - P2887 P2888 - P2907

210. Occupational respiratory diseases: asthma, silicosis and asbestosis .................................376s 211. Respiratory muscles at rest and during exercise: from physiology to clinical context .....381s 220. Hot topics on airway diseases: new horizons in treatment................................................386s 221. New evidence for NIV in the chronic setting ....................................................................388s 222. The best abstracts in physical inactivity and exercise training in COPD ..........................390s 223. Immunological diagnosis of tuberculosis and latent tuberculosis infection......................393s 224. New frontiers for EBUS-TBNA: the mediastinum and beyond........................................395s 225. Management of respiratory diseases in primary care ........................................................396s 226. Phenotyping asthma: clinical severity, comorbid conditions response to treatment? .......399s 227. Ask, see and do: old and new technology in sleep disordered breathing ..........................403s 228. Neonatal and paediatric intensive care ..............................................................................407s 229. Difficult and rare respiratory infections ............................................................................411s 230. COPD and tobacco management.......................................................................................416s 231. Cystic fibrosis: basic and applied science .........................................................................419s 232. Asthma at the bedside ........................................................................................................424s 233. COPD mechanisms ...........................................................................................................428s 234. COPD biomarkers .............................................................................................................433s 235. Modern approach to various clinical settings ....................................................................438s 236. Lung infections: a clinical point of view ...........................................................................443s 237. The latest insights in pulmonary rehabilitation (part 1) ....................................................446s 238. The latest insights in pulmonary rehabilitation (part 2) ....................................................451s 239. Morphologic imaging ........................................................................................................456s 240. Functional imaging ............................................................................................................459s 241. Bronchoscopic treatment of COPD and asthma: where are we going? ............................462s 242. Interventional procedures for diagnosis of diffuse lung diseases and peripheral pulmonary lesions ..............................................................................................................467s 243. Diffuse pulmonary fibrosis ................................................................................................472s 244. Diffuse parenchymal lung disease I ..................................................................................477s 245. Diffuse parenchymal lung disease II .................................................................................482s 246. Quality of life and respiratory symptoms in primary care COPD populations .................487s 247. Early diagnosis and effectiveness of disease management in primary care ......................492s 248. Acute respiratory failure, ARDS and severe COPD exacerbations ...................................497s 249. Infection, sepsis and outcomes in ICU ..............................................................................502s 250. Long-term NIV: COPD, sleep, obesity and outcomes ......................................................506s 251. NIV in the acute setting: growing experience and novel applications ..............................513s 252. Respiratory and cardiovascular abnormalities in COPD: the role of exercise, nutritional status and inflammation ...................................................................................517s 253. Clinical respiratory physiology in different diseases ........................................................521s 254. A metabolic medley: sleep disordered breathing...............................................................527s 255. The heart of the matter: sleep disordered breathing ..........................................................532s 256. Have we advanced in the treatment of sleep disordered breathing? .................................537s 257. Pulmonary circulation: chronic thromboembolic pulmonary hypertension, imaging and biomarkers...................................................................................................................542s 258. Pulmonary circulation: clinical pulmonary hypertension I ...............................................547s 259. Pulmonary circulation: clinical pulmonary hypertension II ..............................................553s 260. Chest wall and pleura ........................................................................................................557s 261. Clinical studies in lung transplantation .............................................................................561s 262. Biomarkers, diagnosis and outcome of respiratory infections ..........................................567s 263. Respiratory infections: a combination of problems needing early treatment....................572s 264. Antibiotics, resistance and vaccines ..................................................................................577s 265. Manifestations, scores and prognosis of community-acquired pneumonia ......................582s 266. Diagnostic features of tuberculosis I .................................................................................586s 267. Tuberculosis: clinical aspects ............................................................................................591s 268. Drug-resistant tuberculosis ................................................................................................596s 269. Tuberculosis and latent tuberculosis infection: diagnosis and treatment ..........................600s 270. Tuberculosis: epidemiology and public health management I ..........................................605s 271. Lung cancer resection and radiotherapy and thoracic oncology late breaking abstracts ..............................................................................................................609s 272. New methods for diagnostic workup of lung cancer.........................................................614s vii

Contents

P2908 - P2926 P2927 - P2944 3013 - 3020 3021 - 3028 3029 - 3036 3037 - 3044 3045 - 3052 3053 - 3060 3061 - 3068 P3069 - P3085 P3086 - P3103 P3104 - P3121 P3122 - P3139 P3140 - P3157 P3158 - P3175

273. Prognostic factors and subtyping of lung cancer...............................................................620s 274. Diagnosis and management of pleural and mediastinal diseases ......................................625s 300. The best of paediatric asthma and allergy .........................................................................629s 301. The different modalities for current imaging and for future issues ...................................631s 302. Novel mechanisms for established drugs for asthma and COPD management ................634s 303. Asthma and COPD: diseases with different phenotypes ...................................................636s 304. Of mice and men: sleep disordered breathing ...................................................................639s 305. Women and tobacco ..........................................................................................................641s 306. Sarcoidosis ........................................................................................................................643s 307. Clinical problems in mediastinal and pleural malignancies ..............................................645s 308. Interventional pulmonology and pleural diseases .............................................................649s 309. Basic research on lung cancer ...........................................................................................653s 310. The pulmonary epithelium: recent developments .............................................................657s 311. Studies of asthma in man...................................................................................................661s 312. Exercise, physiotherapy techniques and assessment in COPD .........................................666s

Tuesday, September 10th 2013 3296 - 3303 3304 - 3311 3316 - 3323 3324 - 3331 3332 - 3339 3340 - 3347 P3348 - P3365 P3366 - P3383 P3384 - P3401 P3402 - P3419 P3420 - P3437 P3438 - P3455 3487 - 3494 3495 - 3502 3503 - 3510 3511 - 3518 3519 - 3526 3527 - 3534 3535 - 3542 P3543 - P3560 P3561 - P3578 P3579 - P3595 P3596 - P3613 P3614 - P3631 P3632 - P3649 P3650 - P3668 P3669 - P3688 P3689 - P3708 P3709 - P3728 P3729 - P3748 P3749 - P3765 P3766 - P3781 P3782 - P3801 P3802 - P3821 P3822 - P3841 P3842 - P3861 P3862 - P3881

337. COPD: markers and inflammation ....................................................................................671s 338. A paediatric palimpsest: sleep apnoea from conception to the teenage years ...................673s 340. COPD and infections .........................................................................................................674s 341. Translational studies in chronic repair and remodelling in the lung .................................676s 342. Rehabilitation, exercise and adjunct physiotherapy techniques in different respiratory conditions ........................................................................................................678s 343. Smoking cessation for healthy and non-healthy smokers .................................................680s 344. New treatments and old dilemmas in the clinical management of lung diseases..............682s 345. Idiopathic pulmonary fibrosis: clinical view .....................................................................687s 346. New clinical trials of asthma and COPD drugs.................................................................692s 347. Pulmonary circulation: clinical science and treatment ......................................................697s 348. Clinical physiology and functional imaging in health and disease ...................................702s 349. Comorbidities and respiratory disease and late-breaking abstracts...................................707s 357. Respiratory physiology in health and disease ...................................................................712s 358. Asthma and lung development: from genes to environment .............................................714s 359. New approaches in patient and staff education .................................................................717s 360. New insights into epigenetic mechanisms in the lung ......................................................719s 361. Idiopathic pulmonary fibrosis: pathogenesis .....................................................................721s 362. Epidemiological and public health features of tuberculosis..............................................723s 363. Treatment of asthma ..........................................................................................................725s 364. Assessment of airway inflammation by exhaled gases......................................................727s 365. The best posters in pulmonary rehabilitation ....................................................................731s 366. Twist in the tale: treating sleep disordered breathing - new technologies, new techniques...................................................................................................................736s 367. Cystic fibrosis: physiotherapy, exercise and lung function in adults and children............740s 368. Indoor and outdoor pollutants: ventilation, sprays, diesel particles, asthma and COPD ..........................................................................................................................744s 369. Asthma and COPD management: novel clinical findings .................................................749s 370. COPD treatment and others...............................................................................................754s 371. COPD treatment ................................................................................................................758s 372. The latest insights in exercise testing and physical inactivity ...........................................763s 373. The latest insights in chronic care .....................................................................................769s 374. The latest insights in respiratory muscles, neuromuscular disease and comorbidities .....773s 375. Therapeutical bronchoscopy for treatment of airway disorders: laser, stents and more ...778s 376. Comfort, safety and effectiveness of bronchoscopy .........................................................783s 377. Sarcoidosis and other granulomatosis ...............................................................................788s 378. Diffuse parenchymal lung disease III ................................................................................792s 379. Treatment and management of asthma in primary care ....................................................797s 380. Long-term NIV: children, neuromuscular patients and technical aspects .........................802s 381. Macrophages, mononuclear cells and viral infection ........................................................808s viii

Contents

P3882 - P3900 P3901 - P3920 P3921 - P3936 P3937 - P3955 P3956 - P3975 P3976 - P3995 P3996 - P4015 P4016 - P4035 P4036 - P4055 P4056 - P4075 P4076 - P4095 P4096 - P4115 P4116 - P4135 P4136 - P4155 P4156 - P4175 P4176 - P4195 P4196 - P4215 P4216 - P4235 P4236 - P4255 P4256 - P4275 P4276 - P4295 P4296 - P4315 P4316 - P4334 P4335 - P4351 P4352 - P4371 P4372 - P4391 P4392 - P4411 P4412 - P4422 P4423 - P4442 P4443 - P4462 P4463 - P4482 P4483 - P4502 P4503 - P4521 P4522 - P4541 4612 - 4619 4620 - 4627 4628 - 4635 4636 - 4643 4644 - 4651 4652 - 4656 P4657 - P4674 P4675 - P4692 P4693 - P4710 P4711 - P4728 P4729 - P4746 P4747 - P4764

382. Stress responses and T-cell behaviour in the lung .............................................................813s 383. The multiple faces of stress in lung injury ........................................................................817s 384. The role of hormones and cytokines in lung injury...........................................................822s 385. New issues in lung function testing...................................................................................826s 386. Clinical exercise physiology .............................................................................................831s 387. Various issues in clinical respiratory physiology ..............................................................836s 388. Sleep disordered breathing in special situations I .............................................................842s 389. Sleep disordered breathing in special situations II ............................................................847s 390. Sleep disordered breathing in special situations III...........................................................852s 391. Pulmonary circulation: clinical treatment .........................................................................857s 392. Pulmonary circulation: clinical diagnosis, imaging, biomarkers and treatment ...............862s 393. Pulmonary circulation: acute pulmonary thromboembolism ............................................867s 394. Asthma drugs: new findings ..............................................................................................873s 395. COPD drugs: new findings ................................................................................................877s 396. Diagnosis and management of respiratory diseases ..........................................................883s 397. Monitoring respiratory diseases: role of comorbidities and lung involvement .................888s 398. Epidemiology of respiratory disease .................................................................................894s 399. Factors associated with outcomes in COPD......................................................................899s 400. Environmental and occupational respiratory diseases: new exposure assessment methods, experimental exposure in animal and humans and mechanisms ........................904s 401. Tobacco use in different countries: crisis to disease..........................................................909s 402. Assessing sleep disordered breathing and lung function in children.................................913s 403. Asthma treatment and management in children ................................................................918s 404. Paediatric respiratory epidemiology: bronchiolitis and asthma ........................................922s 405. Surgery for pleuropulmonary and mediastinal benign diseases ........................................927s 406. Interesting cases of respiratory infections .........................................................................931s 407. Bacterial, fungal and mycobacterial infections .................................................................936s 408. Research questions on how viruses affect the respiratory system.....................................941s 409. Non-tuberculous mycobacteria: clinical management ......................................................945s 410. Diagnostic features of tuberculosis II................................................................................948s 411. Tuberculosis: epidemiology and public health management II .........................................953s 412. Tuberculosis: epidemiology and public health management III .......................................958s 413. Systemic therapy of lung cancer and quality of life ..........................................................962s 414. Pathogenesis and risk of lung cancer ................................................................................967s 415. Other thoracic tumours, particular circumstances and rare cases .....................................972s 438. Back to basics: the upper airway and physiology in sleep disordered breathing ..............976s 439. Tuberculosis susceptibility: genetic polymorphism and vitamin D deficiency .................978s 440. LAMA, LABA, ICS and their combinations for the treatment of asthma and COPD ..........................................................................................................................980s 441. Biology and molecular pathology of lung cancer .............................................................982s 442. Treating bronchiectasis in respiratory patients ..................................................................985s 443. The best abstracts in pulmonary rehabilitation and chronic care (sponsored by MOTEK Medical) ..............................................................................................................987s 444. Lung function and sleep studies in children: technical aspects and clinical applications ........................................................................................................................989s 445. Tuberculosis: clinical epidemiology and public health .....................................................993s 446. Lung function tests to monitor airway diseases ................................................................998s 447. Risk factors for COPD and lung function decline...........................................................1002s 448. Cell signalling and inflammation: what’s new in 2013? .................................................1007s 449. New evidence for NIV in the acute setting .....................................................................1012s

Wednesday, September 11th 2013 4824 - 4831 4832 - 4839 4840 - 4847 4848 - 4855 4856 - 4863

462. Quality management in thoracic oncology......................................................................1018s 463. Pulmonary circulation: clinical physiology.....................................................................1020s 464. Interesting research questions .........................................................................................1022s 465. The best abstracts in extra-pulmonary features and pulmonary rehabilitation ...............1025s 466. Emerging new targets for the treatment of respiratory diseases......................................1027s ix

Contents

4864 - 4871 4872 - 4879 P4880 - P4897 P4898 - P4915 P4916 - P4933 P4934 - P4950 P4951 - P4965 P4966 - P4983 5005 - 5012 5013 - 5019 5020 - 5027 5028 - 5035 5036 - 5043 5044 - 5051 5052 - 5059 P5060 - P5077 P5078 - P5095 P5096 - P5113 P5114 - P5131 P5132 - P5149 P5150 - P5167

467. Investigating COPD in longitudinal studies ....................................................................1029s 468. Molecular biology: state-of-the-art 2013 ........................................................................1031s 469. Growth factors at the crossroads of acute and chronic inflammation .............................1033s 470. Monitoring symptoms and quality of life ........................................................................1037s 471. Mechanical ventilation and weaning ...............................................................................1042s 472. Smoking cessation ...........................................................................................................1047s 473. VATS, interventional endoscopy and tracheal surgery ....................................................1051s 474. New physiologic boundaries ...........................................................................................1054s 480. New molecular and cell biology mechanisms .................................................................1059s 481. Paediatric bronchology ....................................................................................................1061s 482. Origins and diagnosis of asthma .....................................................................................1063s 483. Burn after reading: inflammation in sleep disordered breathing .....................................1065s 484. A modern approach to lung diseases: from bronchi to pleura .........................................1067s 485. Recent developments in pneumonia ................................................................................1069s 486. Cystic fibrosis: lung function and change of lung function in infants and children before and after treatment ................................................................................................1071s 487. Exercise, physiotherapy techniques and assessment in different chronic conditions .....1073s 488. Progress in bronchoscopy and pathology techniques for diagnosis of thoracic malignancies ....................................................................................................................1078s 489. The best posters in chronic care ......................................................................................1082s 490. Connective tissue disease and interstitial lung disease ...................................................1087s 491. Mechanisms contributing to exercise limitation in health and respiratory, cardiac and pulmonary vascular diseases .....................................................................................1092s 492. Pulmonary circulation: basic science ..............................................................................1097s

Abstracts of the Eleventh ERS Lung Science Conference, Estoril, Portugal – March 15-17, 2013 .........................................................................................................1102s Author Index..........................................................................................................................................................1123s Subject Index.........................................................................................................................................................1209s

x

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SUNDAY, SEPTEMBER 8TH 2013 dyspnoea, poorer health-related QoL, shorter 6 MWD, higher HR, and increased ADM. EH was associated with greater deterioration of the health-related QoL (SGRQ activity score ,p=0.038) and SF-36 (physical function, p=0.034), higher severe exacerbation (p=0.006) and death (p=0.02) annual rates. In the UV analysis, MMRC, 6MWD, FEV1% pred, and ADM but not age and Charlson score were associated with EH. In the MV analysis, besides FEV1%pred (p50%) but high ADM levels (>1nmol/l) presented increased risk (40%) for EH Conclusion: Exertional desaturation is common and associated with poorer clinical outcomes in stable COPD. ADM improves prediction of exertional desaturation.

40. Guidelines and exacerbations 172 Hospital adherence to GOLD guidelines for COPD exacerbation. Results of the European CODP audit Jose Luis Lopez-Campos1, Michael Roberts2, Francisco Pozo-Rodriguez3, Sylvia Hartl4. 1 Unidad Medico-Quirurgica De Enfermedades Respiratorias, Hospital Universitario Virgen Del Rocio, Seville, Spain; 2Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom; 3Instituto De Investigacion I+12, Hospital 12 De Octubre, Madrid, Spain; 4Respiratory Department, Ludwig Boltzmann Institute of COPD and Respiratory Epidemiology, Vienna, Austria Objectives. Understanding how European care of COPD admissions varies against guideline standards provides an opportunity to target appropriate quality improvement interventions. We aimed to analyse health care provided to COPD admissions against GOLD guidelines. Methods. In 2010-11 an audit of care against the 2010 GOLD standards was performed in 16018 patients from 384 hospitals in 13 countries. Clinicians prospectively identified consecutive COPD admissions over an 8 week period recording clinical care measures on a web based data-tool. Data were analysed comparing adherence to 10 key guideline standards in GOLD 2010. Results. The subjects comprised 67.8% males, mean age 70.8 (SD 10.8) years, mean FEV1 44.04 (SD 17.4)%. Adherence varied between hospitals and across countries. Average compliance is reflected in the table. Altogether 15.3% fulfilled all 10 recommendations. Guideline recommendation adherence Audit Standard Spirometry result available at admission Arterial Blood Gas performed at admission Chest radiograph performed at admission Controlled oxygen therapy used Short-acting bronchodilator use Non-use of Intravenous methylxanthines Systemic corticosteroids given Antibiotics given if sputum purulence or IMV NIV given if pH 6kPa IMV given if pH 8kpa

174 The utility of echocardiography in elderly smokers with COPD and of spirometry in elderly smokers with CHF Alessiha Verduri1, Bianca Beghé1, Barbara Bottazzi2, Alessandro Fucili3, Alberto Papi3, Licia Ballerin4, Mariarita Stendardo3, Alberto Mantovani2,5, Claudio Ceconi3, Leonardo M. Fabbri1, Piera Boschetto3. 1 Department of Oncology Haematology and Respiratory Diseases, University of Modena  Reggio Emilia, Modena, Italy; 2Research Laboratory Immunology  Inflammation, Humanitas Clinical and Research Center, Rozzano, Milano, Italy; 3Department of Medical Sciences, University of Ferrara, Ferrara, Italy; 4 Respiratory Physio-Pathology Unit, Hospital-University of Ferrara, Ferrara, Italy; 5Department of Translational Medicine, University of Milan, Milano, Italy In spite of sharing common risk factors, in particular cigarette smoking, and aetiological substratum like low-grade systemic inflammation, chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) have been studied mostly separately. We investigated the coexistence of left ventricular dysfunction in COPD patients and of airway obstruction in CHF patients. Patients aged ≥50 years and with 10 pack/years of cigarette smoking presenting with a diagnosis of stable COPD (n=70) or stable CHF (n=124) were recruited. All COPD patients underwent routine echocardiographic assessment and Nt-pro brain natriuretic peptide (BNP) measurements, and all CHF patients underwent routine spirometry. Also, plasma levels of high sensitivity C reactive protein (hsCRP), interleukin (IL)-6, IL-1 and its decoy receptor (IL-1RII), and pentraxin 3 (PTX3) were determined by using a sandwich enzyme-linked immunosorbent assay in all patients and in 24 healthy smokers. We did not detect ventricular dysfunction in COPD patients, whereas the occurrence of airway obstruction among CHF patients was 34%. COPD patients had higher plasma levels of hsCRP and IL-1 as compared with CHF and healthy subjects (p 10 PY and GOLD II-IV seeking care in pulmonary tertiary hospitals in 8 European countries and included in the PROMISE cohort. SP and microbiology were assessed at baseline and each semi-annual visit for a median observation time of 24 months RESULTS At baseline, spontaneuous sputum samples were obtained in 241 (65.0%) of the 371 patients reporting chronic bronchitis. Potentially pathogenic bacteria were isolated in 54 (30.7%) and ruled out in 122 cases with representative sputum specimens. The annual deterioration of dyspnea scores and lung function, health-related QoL, peripheral oxygenation and exercise capacity were similar in patients with and without chronic bacterial airway infection. Conversely, patients with SP presented higher annual exacerbation rates, irrespective of the presence or absence of chronic bacterial airway infection. In the multivariable regression analysis, SP with positive (OR 2.39, p=0.004) and negative (OR 1.58, p=0.032) microbiology, and FEV1% pred (OR 0.99, p=0.0093) but not age adjusted Charlson score (OR 0.92, p=0.091) remained independently associated with frequent exacerbations (2/year) CONCLUSION Spontaneous SP is associated with higher exacerbation rates independently of chronic bacterial airway infection.

did not significantly differ to group 2 (19.2±4.3, p>0.05), and was higher than in group 3 (17.2±6.1, p=0.023). Most of group 3 pts (15/17, 88,2%) scored 10 or more by CAT. CAT scores significantly correlated with PHQ-9 depression scores in group 1 (r=0.58, p=0.03), but not in the other groups (p>0,05). In group 1 neither pts’ nor physicians’ perceptions about the “pivotal disease” significantly correlated with pts’ CAT scores. This indicates the difficulties in differentiating pulmonary and cardiac genesis of symptom burden and its role in the health status impairment. Conclusions. CAT scores may be significantly distorted by CVCM and, possibly, depression. Further validation of CAT in COPD pts with CVCM and other comorbidities is warranted. 178 Left ventricular dysfunction in patients with COPD: Inflammation and endothelial dysfunction Natalia Kuzubova, Aleksei Gichkin, Ekatherina Surkova, Olga Titova. Scientific Research Institute of Pulmonology, Pavlov State Medical University of St.Petersburg, Saint-Petersburg, Russian Federation The aim of the study - to identify the role of systemic inflammation and endothelial dysfunction in the development of left ventricular dysfunction in patients with chronic obstructive pulmonary disease (COPD). Materials and methods. Endothelium-dependent vasodilatation of brachial artery (EDVD), echocardiography data of left and right heart chambers, the concentration of pro-inflammatory and anti-inflammatory cytokines and circulating immune complexes (CIC) in plasma were studied in 60 patients with moderate COPD. Results. COPD patients showed a reduction of left ventricular contractile activity compared to the control group. Reducing EDVD was found in 72% of patients with COPD. In the development of left ventricular failure involved a disorder of interventricular interaction. Correlation analysis of the relationship of molecular indicators of inflammatory activity and echocardiography data were identified: correlation between the concentration of the CIC and the pulmonary artery systolic pressure (PASP), between the level of IL-1 and PASP, between the concentration of IL-8 and the PASP. Conclusions. COPD patients at an early stage of the disease to detect violations of vasoactive endothelial function, an imbalance of pro- and anti- inflammatory cytokines, increasing the concentration of CIC. Developing systemic inflammation and endothelial dysfunction contribute not only to the formation of pulmonary hypertension and chronic cor pulmonale, but also the development of left ventricular failure.

176 Pneumonia risk in COPD patients on long term inhaled corticosteroids – Data from the European COPD audit