Redo mitral valve replacement in an adult with severe pulmonary hypertension resulting from structural valve deterioration and left ventricular outflow tract obstruction and a history of atrioventricular septal defect repair: a case report
Emphysema At CT Lung Screening Increases Death Risk In Asymptomatic Adults: Study
Emphysema detected on baseline low-dose chest CT (LDCT) in the lung cancer screening cohort of more than 9,000 asymptomatic adults was associated with death from all causes, chronic obstructive pulmonary disease (COPD), and cardiovascular disease within a 25-year follow-up period in a new study published today in Radiology, a journal of the Radiological Society of North America (RSNA).
Emphysema is a permanent and progressive lung disease in which air sacs in the lungs become damaged, making breathing difficult. It is primarily caused by long-term exposure to irritants like cigarette smoke and air pollution.
"Until now, we didn't know if baseline visual emphysema scoring on LDCT in the lung cancer screening setting had any prognostic value," said Claudia I. Henschke, Ph.D., M.D., a radiologist and professor of radiology in the Department of Diagnostic, Molecular, and Interventional Radiology at Icahn School of Medicine at Mount Sinai, in New York. "Our study stands out for its long follow-up and comprehensive analysis of the causes of death in a large lung cancer screening cohort."
In the study, a lung cancer screening cohort of 9,047 asymptomatic adults (ages 40-85 at enrollment; 4,614 female) with a smoking history underwent baseline LDCT in New York and were followed for up to 25 years as part of the International Early Lung Cancer Action Program (I-ELCAP).
Participants (median age 65 years, median pack-years 43, and median follow-up 23.3 years) underwent baseline LDCT between 2000 and 2008 and were followed when possible until death or December 31, 2024. Pack-years is a measure of lifetime exposure to cigarette smoke calculated by multiplying the number of years spent smoking by the number of cigarette packs smoked per day.
An experienced chest radiologist assessed each LDCT and assigned a score reflecting the level of emphysema present from 0 (none) to 3 (severe).
"Lung cancer screening shouldn't just be looking for nodules," said Dr. Henschke, principal investigator for the I-ELCAP. "That's a small part of what we see on the CT scan. As radiologists, we're responsible for the entire image."
Among the study's participants, 70.9% had no evidence of emphysema. The percentage of mild, moderate and severe emphysema was 21.1%, 5.7%, and 2.4%, respectively. Nearly 80% of participants identified with emphysema on their baseline LDCT had not been previously diagnosed, including five percent of participants with moderate or severe emphysema.
Slightly more males than women were diagnosed with emphysema (30.1% versus 28.2%). Evidence of the disease increased with advanced age and higher cumulative smoking exposure.
By year-end 2024, 3,738 participants (41.3%) had died, most commonly from cardiovascular disease (12.7%) and COPD (3.3%). The median age at the time of death from all causes was 81, and from COPD, cardiovascular disease, and other causes, it was 81, 82, and 81 years, respectively.
A statistical analysis of associations between emphysema and mortality demonstrated that the lung disease was associated with COPD mortality but not cardiovascular disease mortality.
"Clinically, these findings suggest emphysema is not merely an incidental CT finding, but a distinct disease entity associated with worst outcomes and increased mortality, not only from lung cancer but also from respiratory and cardiovascular diseases," Dr. Henschke said. "The findings show an increased risk of all causes of death by the presence of emphysema and its severity, ranging from a 1.15-fold increase for mild disease and a 2.28-fold increase for severe emphysema. For deaths due to COPD, the increased risk ranged from a 2.07-fold for mild disease to 12.06-fold increase for severe emphysema."
The study's results will enable healthcare providers to tailor risk-based treatment to prevent the progression of the disease. Dr. Henschke said using a visual assessment of emphysema as a predictor of health two decades into the future is part of a new era of preventive health.
"The amount of information you get and the ability to act on it in a meaningful way is something preventive health only dreamed of being just a few years ago," she said.
Dr. Henschke envisions a comprehensive lung cancer screening program that also assesses COPD and cardiovascular disease risk to identify individuals who may benefit from interventions to improve outcomes.
"Pulmonologists, cardiologists and radiologists need to work together, because one influences the other," she said. "We have to work towards solutions holistically."
Although the United States Preventive Services Task Force recommends annual lung cancer screening with LDCT for adults aged 50 to 80 who have a 20 pack-year smoking history and currently smoke or quit within the past 15 years, Dr. Henschke said she would also like to see screening benefits extended to individuals who have never smoked.
"In the U.S., about 30,000 to 40,000 deaths each year are found in non-smokers," she said. "That's about a third of the total deaths due to lung cancer annually."
Reference:
Jessica González Gutiérrez, Rowena Yip, Javier J. Zulueta, Samuel M. Aguayo, Daniel M. Libby, Mark W. Pasmantier, Emphysema at Baseline Low-Dose CT Lung Cancer Screening Predicts Death from Chronic Obstructive Pulmonary Disease and Cardiovascular Disease Up to 25 Years Later, Radiology, https://doi.Org/10.1148/radiol.250949
Detection Of Emphysema: A Critical Opportunity To Enhance Lung Cancer Screening
Recent research published in The Annals of the American Thoracic Society confirms that emphysema was detected in 24% to 31% of patients undergoing lung cancer screening. This means that for millions of Americans, lung cancer screenings can serve as a detection tool for emphysema.
"Medicine is rarely gifted with such a high-yield opportunity to move beyond the individual disease silo to better manage these shared comorbid conditions," write the study's authors.
According to U.S. Preventive Services Task Force (USPSTF) guidelines, approximately 15 million people are now eligible for screening. If fully implemented, up to 3 million individuals could be newly diagnosed with emphysema, enabling earlier and more targeted interventions.
Options for severe emphysema patients
Emphysema is a progressive disease. Until recently, emphysema findings were often not acted upon because they did not always trigger additional care. The standard of care for advanced emphysema patients has traditionally included bronchodilators (inhalers), pulmonary rehabilitation, and in the most severe cases, lung-volume reduction surgery or lung transplantation. Yet, a significant gap remained in treatment options – medical management still often leaves severe patients symptomatic, and surgical options are invasive and risky, making them seldom used.
Now, however, a minimally invasive standard-of-care option is changing how severe emphysema is managed. This procedure, known as bronchoscopic lung volume reduction (BLVR), is indicated for advanced emphysema patients who remain symptomatic despite maximizing pulmonary rehabilitation and medication.
The Zephyr® Valve procedure, a type of BLVR treatment, is approved for these patients. About the size of a pencil eraser, the valves are bronchoscopically placed – with no cutting – in the most diseased part of the lung. The one-way valves release trapped air, helping inhaled oxygen reach healthier tissue, allowing patients to breathe easier and increase activity levels.1 The procedure is clinically proven, backed by extensive research, and reversible, as the valves can be removed if necessary. (See risks associated with this procedure here.)
Quality of life may improve
While BLVR treatment is not a cure, it is an effective intervention that helps patients regain independence in daily activities by improving their breathing. Many patients report being able to walk longer distances without stopping for breath, climb the stairs without extreme breathlessness, and complete everyday tasks – such as shopping or household chores – with greater ease.1
Diagnosis impacts population health
Diagnosing emphysema allows for appropriate management of patients at all stages of the disease. Importantly, this provides access for unrecognized severe cases to advanced, minimally invasive treatments such as BLVR with Zephyr valves.
What can hospitals do?
Hospitals and healthcare systems can take proactive steps to ensure lung cancer screening serves as a more comprehensive tool for detecting and managing lung diseases. A key priority is standardizing radiological reporting of emphysema identified by lung cancer screening and ensuring that findings are clearly communicated to both patients and referring providers. According to the study's authors, three options for achieving this include:
As research continues to refine best practices, integrating emphysema detection into lung cancer screening workflows can drive better patient outcomes and expand preventative care for high-risk populations.
More information on lung cancer and emphysema screenings is available through the American Lung Association. To learn more about Zephyr Valves and BLVR treatment, visit Pulmonx.Com.
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Links:
https://www.Atsjournals.Org/doi/10.1513/AnnalsATS.202207-631PS?Url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.Org&rfr_dat=cr_pub%20%200pubmed#:~:text=Track%20Citations-,Emphysema%20Detection%20in%20the%20Course%20of%20Lung%20Cancer%20Screening%3A%20Optimizing%20a%20Rare%20Opportunity%20to%20Impact%20Population%20Health,-James%20L.%20Mulshine
The importance of low-dose CT screening to identify emphysema in asymptomatic participants with and without a prior diagnosis of COPD – Clinical ImagingIncidental Findings on Low-Dose CT Scan Lung Cancer Screenings and Deaths From Respiratory Diseases – CHEST
U.S. Preventive Services Task Force (USPSTF) guidelines
How It Works: Zephyr Valve Treatment for COPD & Emphysema
PulmonxReferences and Bibliography
PulmonxZephyr Valve Prescriptive Information
Lung Cancer Screening ResourcesAmerican Lung Association
www.Pulmonx.Com
Heart-healthy Habits Prevent Cancer, Alzheimer's, COPD, Other Diseases
Simple heart-healthy habits can boost brain power, protect your senses, and reduce disease risks across the body. (CREDIT: CC BY-SA 4.0)
In 2010, the American Heart Association (AHA) introduced a new way to define cardiovascular health. This approach, known as Life's Simple 7, or LS7, shifted the focus from treating heart disease to preventing it. Rather than waiting for illness to strike, it encouraged people to take action early—before symptoms ever appeared.
The LS7 score combined seven key elements: not smoking, eating healthy, staying active, maintaining a healthy weight, and controlling blood pressure, cholesterol, and blood sugar. A few years later, the AHA expanded this to Life's Essential 8 by adding sleep to the list.
Now, over a decade later, a groundbreaking study from Emory University shows how far-reaching the benefits of these habits really are. Published in the Journal of the American Heart Association, the review draws on nearly 500 studies to show that keeping your heart healthy also protects your brain, lungs, muscles, and even senses like sight and hearing.
The LS7 score combined seven key elements: not smoking, eating healthy, staying active, maintaining a healthy weight, and controlling blood pressure, cholesterol, and blood sugar. (CREDIT: iStock / facfotodigital)
A Healthier Heart Supports a Stronger BrainThe study reveals that habits that protect your heart also sharpen your mind. Regular physical activity, nutritious meals, and good sleep help keep blood vessels strong and promote good blood flow to the brain. This helps delay or even prevent diseases like Alzheimer's and dementia.
Exercise boosts the birth of new brain cells and strengthens the connections between them. Foods rich in antioxidants and healthy fats protect against cell damage. Sleep helps clear out harmful waste from the brain, while low stress keeps your mind sharp.
According to Dr. Liliana Aguayo, lead researcher of the study and professor at Emory's School of Nursing, the link between heart and brain health is much stronger than once believed. She explains, "Almost every organ system and bodily function from head to toe benefit from a heart-healthy lifestyle."
Related Stories Clearer Sight, Sharper Hearing, and Stronger TeethSurprisingly, heart-friendly habits also protect your eyes, ears, and mouth. High blood pressure, for example, can damage the tiny vessels in your eyes and ears, leading to vision loss or hearing problems. Smoking and poor nutrition also speed up tooth decay and gum disease.
By staying active, eating a vitamin-rich diet, and keeping your blood pressure in check, you improve the flow of oxygen and nutrients to your sensory organs. That helps them function better for longer. And giving up smoking has immediate benefits for your senses and oral health. The study also found that regular movement improves circulation, which keeps your teeth, eyes, and ears healthier as you age.
Fewer Chronic Diseases, Longer LifeOne of the strongest messages from the Emory review is that heart-healthy habits do far more than just protect your heart. They dramatically reduce your chances of developing many major diseases. These include type 2 diabetes, cancer, chronic lung disease, kidney failure, fatty liver disease, depression, and even infections like pneumonia.
Benefits to human health associated with optimal cardiovascular health: optimal health from brain to toe. (CREDIT: JAMA)
Researchers found that people who scored high on the LS7 or the updated Essential 8 had fewer hospital visits and lower healthcare costs. They also experienced better mobility, fewer disabilities, and longer life spans. Maintaining a healthy weight and eating well help regulate metabolism, prevent inflammation, and strengthen the immune system. Regular exercise boosts insulin sensitivity and lung function, while stress management keeps hormone levels stable.
By practicing these habits every day—eating balanced meals, moving your body, getting good sleep, and avoiding tobacco—you reduce the load on your organs and protect yourself against many types of illness.
Better Mood, Less StressGood physical health is closely tied to mental well-being. People who follow heart-healthy routines report feeling less stressed and more emotionally balanced. Exercise releases feel-good chemicals in the brain, while healthy foods fuel your mood by supporting brain chemistry. Adequate sleep improves emotional control, and mindfulness practices help reduce the body's main stress hormone, cortisol.
The Emory study found that these habits often go hand in hand. People who exercise tend to sleep better. Those who eat well often experience more stable moods. And when you manage your stress, you're more likely to make healthier choices overall. This creates a positive cycle that improves both mental and physical health at once.
Summary of the determinants, mechanisms, and outcomes associated with ideal/high and poor/low levels of cardiovascular health. (CREDIT: JAMA)
The Role of Lifestyle Brands and Wellness ToolsIn today's digital world, it's easier than ever to track your health and build better habits. Many wellness apps and wearable devices now support heart-healthy living. Fitness trackers can monitor your steps, heart rate, and sleep quality. Nutrition apps offer meal plans tailored to your needs, helping you eat smarter without overthinking it.
Some brands go a step further, combining coaching, community support, and guided challenges to keep you motivated. Products like omega-3 supplements, stress-relief tools, and sleep aids can also help you stay on track. These resources don't replace healthy habits, but they make sticking with them easier.
As researchers point out, even small improvements in your daily routine—like walking more, eating fewer processed foods, or turning off screens before bed—can lead to big changes in your overall health.
American Heart Association's Life's Simple 7 Scoring Criteria for Adult Cardiovascular Health. (CREDIT: JAMA)
Looking Ahead: Health from Head to ToeThe Emory review calls for more studies on underrepresented groups, such as children and pregnant women. It also urges healthcare professionals to include lifestyle advice in regular care, not just when something goes wrong.
Ultimately, the message is clear: taking care of your heart benefits your entire body and mind. Whether it's preventing disease, improving your mood, or helping you stay independent as you age, the rewards of heart-healthy habits go far beyond the heart.
By adopting a few simple practices each day, you create a foundation for lifelong wellness. You don't need to overhaul your life overnight—just start where you are. A walk around the block, a colorful plate of food, or a few extra hours of sleep can all make a meaningful difference.
Note: The article above provided above by The Brighter Side of News.
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