Center for Heart Lung Innovation

Vancouver, Canada

Center for Heart Lung Innovation

Vancouver, Canada

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Bendall C.L.,UBC | Bendall C.L.,Center for Heart Lung Innovation | Wilson D.M.,Center for Heart Lung Innovation | Frison K.R.,Center for Heart Lung Innovation | And 4 more authors.
Canadian Journal of Respiratory Therapy | Year: 2016

This article suggests a method for integrating the principles of Aboriginal knowledge translation (KT) in the implementation of a pilot for chronic obstructive pulmonary disease (COPD) screening to improve current practice and provide health programming that is culturally sensitive and relevant. The elements of the Consolidated Framework for Implementation Research model guided a community informed design for the Lung Health Day that was planned with two communities of the Secwepemc Nation in British Columbia. By integrating the principles of Aboriginal KT, program implementation design can address the current disparities in respiratory care and management of COPD and improve the health status of First Nations patients.


Fung G.,Center for Heart Lung Innovation | Luo H.,Center for Heart Lung Innovation | Qiu Y.,Center for Heart Lung Innovation | Yang D.,Center for Heart Lung Innovation | And 2 more authors.
Circulation Research | Year: 2016

Viral myocarditis remains a prominent infectious-inflammatory disease for patients throughout the lifespan. The condition presents several challenges including varied modes of clinical presentation, a range of timepoints when patients come to attention, a diversity of approaches to diagnosis, a spectrum of clinical courses, and unsettled perspectives on therapeutics in different patient settings and in the face of different viral pathogens. In this review, we examine current knowledge about viral heart disease and especially provide information on evolving understanding of mechanisms of disease and efforts by investigators to identify and evaluate potential therapeutic avenues for intervention. ©2016 American Heart Association, Inc.


Liu J.C.Y.,Center for Heart Lung Innovation | Leung J.M.,Center for Heart Lung Innovation | Ngan D.A.,Center for Heart Lung Innovation | Nashta N.F.,St Pauls Hospital | And 21 more authors.
PLoS ONE | Year: 2015

Combination antiretroviral therapy (cART) has extended the longevity of human immunodeficiency virus (HIV)-infected individuals. However, this has resulted in greater awareness of age-associated diseases such as chronic obstructive pulmonary disease (COPD). Accelerated cellular senescence may be responsible, but its magnitude as measured by leukocyte telomere length is unknown and its relationship to HIV-associated COPD has not yet been established. We measured absolute telomere length (aTL) in peripheral leukocytes from 231 HIV-infected adults. Comparisons were made to 691 HIV-uninfected individuals from a population-based sample. Subject quartiles of aTL were assessed for relationships with measures of HIV disease severity, airflow obstruction, and emphysema severity on computed tomographic (CT) imaging. Multivariable regression models identified factors associated with shortened aTL. Compared to HIV-uninfected subjects, the mean aTL in HIV-infected patients was markedly shorter by 27 kbp/genome (p<0.001); however, the slopes of aTL vs. age were not different (p=0.469). Patients with longer known durations of HIV infection (p=0.019) and lower nadir CD4 cell counts (p=0.023) had shorter aTL. Shorter aTL were also associated with older age (p=0.026), smoking (p=0.005), reduced forced expiratory volume in one second (p=0.030), and worse CT emphysema severity score (p=0.049). HIV-infected subjects demonstrate advanced cellular aging, yet in a cART-treated cohort, the relationship between aTL and age appears no different from that of HIV-uninfected subjects. © 2015 Liu et al.


Pascoe C.D.,University of British Columbia | Pascoe C.D.,St Pauls Hospital | Pascoe C.D.,Center for Heart Lung Innovation | Donovan G.M.,University of Auckland | And 5 more authors.
Journal of Applied Physiology | Year: 2014

Deep inspirations (DIs) taken before an inhaled challenge with a spasmogen limit airway responsiveness in nonasthmatic subjects. This phenomenon is called bronchoprotection and is severely impaired in asthmatic subjects. The ability of DIs to prevent a decrease in forced expiratory volume in 1 s (FEV1) was initially attributed to inhibition of airway narrowing. However, DIs taken before methacholine challenge limit airway responsiveness only when a test of lung function requiring a DI is used (FEV1). Therefore, it has been suggested that prior DIs enhance the compliance of the airways or airway smooth muscle (ASM). This would increase the strain the airway wall undergoes during the subsequent DI, which is part of the FEV1 maneuver. To investigate this phenomenon, we used ovine tracheal smooth muscle strips that were subjected to shortening elicited by acetylcholine with or without prior strain mimicking two DIs. The compliance of the shortened strip was then measured in response to a stress mimicking one DI. Our results show that the presence of "DIs" before acetyl-choline-induced shortening resulted in 11% greater relengthening in response to the third DI, compared with the prior DIs. This effect, although small, is shown to be potentially important for the reopening of closed airways. The effect of prior DIs was abolished by the adaptation of ASM to either shorter or longer lengths or to a low baseline tone. These results suggest that DIs confer bronchoprotection because they increase the compliance of ASM, which, consequently, promotes greater strain from subsequent DI and fosters the reopening of closed airways. Copyright © 2014 the American Physiological Society.


Ryerson C.J.,St Pauls Hospital | Ryerson C.J.,Center for Heart Lung Innovation | O'Connor D.,St Pauls Hospital | Dunne J.V.,St Pauls Hospital | And 6 more authors.
Chest | Year: 2015

BACKGROUND: Mortality risk prediction tools have been developed in idiopathic pulmonary fi brosis, however, it is unknown whether these models accurately estimate mortality in systemic sclerosis-associated interstitial lung disease (SSc-ILD). METHODS: Four baseline risk prediction models-the Composite Physiologic Index, the Interstitial Lung Disease-Gender, Age, Physiology Index, the du Bois index, and the modifi ed du Bois index-were calculated for patients recruited from a specialized SSc-ILD clinic. Each baseline model was assessed using logistic regression analysis with 1-year mortality as the outcome variable. Discrimination was quantifi ed using the area under the receiver operating characteristic curve. Calibration was assessed using the goodness-of-fi t test. Th e incremental prognostic ability of additional predictor variables was determined by adding prespecifi ed variables to each baseline model. RESULTS: The 156 patients with SSc-ILD completed 1,294 pulmonary function tests, 725 6-min walk tests, and 637 echocardiograms. Median survival was 15.0 years from the time of SSc-ILD diagnosis. All baseline models were signifi cant predictors of 1-year mortality in SSc-ILD. Th e modifi ed du Bois index had an area under the receiver operating characteristic curve of 0.84, compared with 0.77 to 0.81 in the other models. Calibration was acceptable for the modifi ed du Bois index, but was poor for the other models. All baseline models include FVC and 6-min walk distance was identified as an additional independent predictor of 1-year mortality. CONCLUSIONS: Th e modifi ed du Bois index has good discrimination and calibration for the prediction of 1-year mortality in SSc-ILD. FVC and 6-min walk distance are important independent predictors of 1-year mortality in SSc-ILD. © 2015 American College of Chest Physicians.


PubMed | University of British Columbia, Dong - A University, St Pauls Hospital, McGill University and Center for Heart Lung Innovation
Type: Journal Article | Journal: PloS one | Year: 2015

Combination antiretroviral therapy (cART) has extended the longevity of human immunodeficiency virus (HIV)-infected individuals. However, this has resulted in greater awareness of age-associated diseases such as chronic obstructive pulmonary disease (COPD). Accelerated cellular senescence may be responsible, but its magnitude as measured by leukocyte telomere length is unknown and its relationship to HIV-associated COPD has not yet been established. We measured absolute telomere length (aTL) in peripheral leukocytes from 231 HIV-infected adults. Comparisons were made to 691 HIV-uninfected individuals from a population-based sample. Subject quartiles of aTL were assessed for relationships with measures of HIV disease severity, airflow obstruction, and emphysema severity on computed tomographic (CT) imaging. Multivariable regression models identified factors associated with shortened aTL. Compared to HIV-uninfected subjects, the mean aTL in HIV-infected patients was markedly shorter by 27 kbp/genome (p<0.001); however, the slopes of aTL vs. age were not different (p=0.469). Patients with longer known durations of HIV infection (p=0.019) and lower nadir CD4 cell counts (p=0.023) had shorter aTL. Shorter aTL were also associated with older age (p=0.026), smoking (p=0.005), reduced forced expiratory volume in one second (p=0.030), and worse CT emphysema severity score (p=0.049). HIV-infected subjects demonstrate advanced cellular aging, yet in a cART-treated cohort, the relationship between aTL and age appears no different from that of HIV-uninfected subjects.

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