PMID- 35811743
OWN - NLM
STAT- MEDLINE
DCOM- 20220712
LR  - 20220724
IS  - 1178-2005 (Electronic)
IS  - 1176-9106 (Print)
IS  - 1176-9106 (Linking)
VI  - 17
DP  - 2022
TI  - Clinical Impact of Compensatory Hyperinflation of the Nontreated Adjacent Lobe 
      After Bronchoscopic Lung Volume Reduction with Valves.
PG  - 1523-1536
LID - 10.2147/COPD.S364448 [doi]
AB  - BACKGROUND: Bronchoscopic lung volume reduction (BLVR) with endobronchial valves 
      (EBV) can be a successful treatment for end-stage emphysema patients. The 
      reduction of hyperinflation enhances ventilatory mechanics and diaphragm 
      function. Understanding predictors for treatment success is crucial for further 
      improvements. PURPOSE: The aim of this study was to assess the effect of the 
      target lobe volume reduction (TLVR) in relation to the ipsilateral lung volume 
      reduction (ILVR), affected by the compensatory expansion of the adjacent lobe, on 
      the outcome after BLVR with valves. PATIENTS AND METHODS: The volumetric 
      relationship of ILVR% to TLVR%, addressed as Reduction Ratio (R), was recorded in 
      82 patients and compared to changes in lung function, physical performance and 
      quality of life. A small value for R implies a relatively low volume reduction of 
      the ipsilateral lung (ILVR) compared to the volume reduction of the target lobe 
      (TLVR). Additionally, the minimal clinically important difference (MCID) for R 
      was calculated. RESULTS: Patients with a smaller Reduction Ratio (R <0.2) showed 
      minor improvements at the 3 months follow-up compared to patients with R >/=0.2 
      (mean changes of 39 mL (5.8%), -395 mL (-4.9%) and 96 mL (7.1%) versus 231 mL 
      (33%), -1235 mL (-20%) and 425 mL (29%) in the forced expiratory volume in 1s 
      (FEV(1)), residual volume (RV) and inspiratory vital capacity (IVC), 
      respectively, and -3 m and 0 points versus 20.4 m and -3.4 points in the 
      6-minute-walking-distance (6MWD) and COPD assessment test (CAT) score 
      respectively). With a combined value of 0.185, a MCID for R was calculated with 
      established anchors (FEV(1), RV, and 6MWD) for emphysema patients. CONCLUSION: 
      Extensive compensatory hyperinflation of the adjacent non-treated lobe after BLVR 
      results in decreased ILVR, which is responsible for a lack of meaningful 
      improvements in ventilatory mechanics and clinical outcome, despite technically 
      successful lobe volume reduction.
CI  - (c) 2022 Wienker et al.
FAU - Wienker, Johannes
AU  - Wienker J
AD  - Department of Pneumology, University Medicine Essen- Ruhrlandklinik, Essen, 
      Nordrhein-Westfalen, Germany.
FAU - Darwiche, Kaid
AU  - Darwiche K
AUID- ORCID: 0000-0003-0681-1325
AD  - Department of Pneumology, University Medicine Essen- Ruhrlandklinik, Essen, 
      Nordrhein-Westfalen, Germany.
FAU - Walscher, Julia
AU  - Walscher J
AD  - Department of Pneumology, University Medicine Essen- Ruhrlandklinik, Essen, 
      Nordrhein-Westfalen, Germany.
FAU - Winantea, Jane
AU  - Winantea J
AD  - Department of Pneumology, University Medicine Essen- Ruhrlandklinik, Essen, 
      Nordrhein-Westfalen, Germany.
FAU - Hagemann, Michael
AU  - Hagemann M
AD  - Department of Pneumology, University Medicine Essen- Ruhrlandklinik, Essen, 
      Nordrhein-Westfalen, Germany.
FAU - Buscher, Erik
AU  - Buscher E
AD  - Department of Pneumology, University Medicine Essen- Ruhrlandklinik, Essen, 
      Nordrhein-Westfalen, Germany.
FAU - Singla, Abhinav
AU  - Singla A
AD  - Department of Pneumology, University Medicine Essen- Ruhrlandklinik, Essen, 
      Nordrhein-Westfalen, Germany.
FAU - Taube, Christian
AU  - Taube C
AD  - Department of Pneumology, University Medicine Essen- Ruhrlandklinik, Essen, 
      Nordrhein-Westfalen, Germany.
FAU - Karpf-Wissel, Rudiger
AU  - Karpf-Wissel R
AD  - Department of Pneumology, University Medicine Essen- Ruhrlandklinik, Essen, 
      Nordrhein-Westfalen, Germany.
LA  - eng
PT  - Journal Article
DEP - 20220701
PL  - New Zealand
TA  - Int J Chron Obstruct Pulmon Dis
JT  - International journal of chronic obstructive pulmonary disease
JID - 101273481
SB  - IM
MH  - Bronchoscopy/adverse effects/methods
MH  - *Emphysema
MH  - Forced Expiratory Volume
MH  - Humans
MH  - Pneumonectomy/adverse effects/methods
MH  - *Pulmonary Disease, Chronic Obstructive
MH  - *Pulmonary Emphysema/diagnostic imaging/surgery
MH  - Quality of Life
MH  - Treatment Outcome
PMC - PMC9257092
OTO - NOTNLM
OT  - emphysema
OT  - ipsilateral lung volume
OT  - reduction ratio
OT  - volume shift
COIS- KD has received speaker fees from Olympus, Boston Scientific, Broncus Medical, 
      Erbe, Bohringer I., Storz; consultant activities at bess, Boston Scientific, 
      Broncus Medical, Fujifilm, FreeFlow, Storz, PulmonX, Bohringer I., Morair 
      Medtech, Medtronic; research grants from Pulmonx, PneumRx, Nuveira, Epigenomics, 
      Broncus, Novartis, Roche, Ambu, Gala Therapeutics. All other authors have no 
      potential conflict of interest.
EDAT- 2022/07/12 06:00
MHDA- 2022/07/14 06:00
PMCR- 2022/07/01
CRDT- 2022/07/11 03:37
PHST- 2022/03/03 00:00 [received]
PHST- 2022/06/09 00:00 [accepted]
PHST- 2022/07/11 03:37 [entrez]
PHST- 2022/07/12 06:00 [pubmed]
PHST- 2022/07/14 06:00 [medline]
PHST- 2022/07/01 00:00 [pmc-release]
AID - 364448 [pii]
AID - 10.2147/COPD.S364448 [doi]
PST - epublish
SO  - Int J Chron Obstruct Pulmon Dis. 2022 Jul 1;17:1523-1536. doi: 
      10.2147/COPD.S364448. eCollection 2022.