Abstract Rationale Breathing-swallowing discoordination has been reported to trigger acute exacerbations (AEs) in patients with chronic obstructive pulmonary disease. However, it remains unclear whether such discoordination is associated with AEs in patients with interstitial lung disease (ILD). We aimed to evaluate breathing-swallowing discoordination in patients with ILD using a non-invasive, quantitative technique and to clarify its relationship with clinical outcomes. Methods We conducted a prospective observational study of patients with ILD referred as potential lung transplant candidates. Swallowing during inspiration (I-SW) and swallowing immediately followed by inspiration (SW-I) were defined as breathing-swallowing discoordination. Participants were classified into high-frequency and low-frequency groups using a 25% cutoff value. We compared patient characteristics, transplant-free survival, and the cumulative incidence of AEs between the two groups. Results A total of 30 patients were enrolled in the study. Nine patients were categorized into the high-frequency group. The high-frequency group included a greater proportion of patients with pleuroparenchymal fibroelastosis (PPFE) (p = 0.049). There were no significant differences in patient background, pulmonary function, or radiological characteristics between the two groups in either the overall cohort or the non-PPFE subgroup. No significant differences in transplant-free survival were observed between the groups in either the overall cohort (p = 0.459) or the non-PPFE ILD subgroup (p = 0.439). Conversely, a higher frequency of I-SW/SW-I patterns was significantly associated with an increased cumulative incidence of AEs, particularly among patients with non-PPFE ILD (p = 0.028 and 0.004, respectively). Conclusions Breathing-swallowing discoordination occurred more frequently in patients with PPFE than in those with non-PPFE ILD. In particular, among patients with non-PPFE ILD, a high frequency of I-SW/SW-I patterns was significantly associated with a higher risk of AEs. This abstract is funded by: Japan Agency for Medical Research and Development
Yamaya et al. (Fri,) studied this question.