PMID- 35813714
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2072-1439 (Print)
IS  - 2077-6624 (Electronic)
IS  - 2072-1439 (Linking)
VI  - 14
IP  - 6
DP  - 2022 Jun
TI  - Clinical outcomes and quantitative CT analysis after bronchoscopic lung volume 
      reduction using valves for advanced emphysema.
PG  - 1922-1932
LID - 10.21037/jtd-21-1734 [doi]
AB  - BACKGROUND: Bronchoscopic lung volume reduction (BLVR) using Zephyr endobronchial 
      valve (EBV) and intrabronchial valve (IBV) has been shown to improve lung 
      function and exercise capacity in severe emphysema. However, changes in airway 
      structures and whether these are related to the clinical improvements remain 
      unclear. METHODS: A retrospective study was performed on patients treated with 
      BLVR. We compared changes in 2nd-, 3rd-, and 4th-generation bronchial structures 
      after therapy, including wall thickness (WT), percentage of wall thickness (WT%), 
      intraluminal area (LA), wall area (WA), and WA%. Responder and non-responder 
      subgroup analysis according to minimum clinically important difference (MCID) 
      which was defined as an improvement of 15% in forced expiratory volume in 1 s 
      (FEV(1)) and 26 m in 6 min walk distance (6MWD) was conducted. RESULTS: Of the 19 
      patients, 11 were treated with EBV and 8 with IBV. In ipsilateral non-target 
      lobes, WT% decreased significantly in 3rd-generation bronchi at 1 month, 3, and 6 
      months, as well as their WA% at 1 month and 6 months. Non-responders, who were 
      unable to achieve MCID, showed no consistent bronchial wall changes. And their LA 
      of 3rd-generation bronchi decreased especially at 1 month. After BLVR, the target 
      lobe volume decreased significantly until 12 months of follow-up. The volume of 
      ipsilateral lobes could increase correspondingly and achieve the best 
      improvements at 6 months. The contralateral lung volume showed slight 
      amelioration but there was no statistical significance. CONCLUSIONS: Both airway 
      structures and lung volumes showed changes after BLVR. The 3rd- and 4th-bronchial 
      walls tend to be thinner, which were consistent with clinical improvements. 
      Further studies are needed to prove this conclusion and find detect potential 
      mechanics.
CI  - 2022 Journal of Thoracic Disease. All rights reserved.
FAU - Guo, Fangfang
AU  - Guo F
AD  - Department of Pulmonary and Critical Care Medicine, Peking University First 
      Hospital, Beijing, China.
FAU - Huang, Junfang
AU  - Huang J
AD  - Department of Pulmonary and Critical Care Medicine, Peking University First 
      Hospital, Beijing, China.
FAU - Hu, Yan
AU  - Hu Y
AD  - Department of Pulmonary and Critical Care Medicine, Peking University First 
      Hospital, Beijing, China.
FAU - Qiu, Jianxing
AU  - Qiu J
AD  - Department of Radiology, Peking University First Hospital, Beijing, China.
FAU - Zhang, Hong
AU  - Zhang H
AD  - Department of Pulmonary and Critical Care Medicine, Peking University First 
      Hospital, Beijing, China.
FAU - Zhang, Wei
AU  - Zhang W
AD  - Department of Pulmonary and Critical Care Medicine, Peking University First 
      Hospital, Beijing, China.
FAU - Cheng, Yuan
AU  - Cheng Y
AD  - Department of Pulmonary and Critical Care Medicine, Peking University First 
      Hospital, Beijing, China.
FAU - Liao, Jiping
AU  - Liao J
AD  - Department of Pulmonary and Critical Care Medicine, Peking University First 
      Hospital, Beijing, China.
FAU - Wang, Guangfa
AU  - Wang G
AD  - Department of Pulmonary and Critical Care Medicine, Peking University First 
      Hospital, Beijing, China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - J Thorac Dis
JT  - Journal of thoracic disease
JID - 101533916
PMC - PMC9264089
OTO - NOTNLM
OT  - Bronchoscopic lung volume reduction (BLVR)
OT  - quantitative CT
OT  - severe emphysema
OT  - valves
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at 
      https://jtd.amegroups.com/article/view/10.21037/jtd-21-1734/coif). The authors 
      have no conflicts of interest to declare.
EDAT- 2022/07/12 06:00
MHDA- 2022/07/12 06:01
PMCR- 2022/06/01
CRDT- 2022/07/11 04:06
PHST- 2021/11/02 00:00 [received]
PHST- 2022/05/09 00:00 [accepted]
PHST- 2022/07/11 04:06 [entrez]
PHST- 2022/07/12 06:00 [pubmed]
PHST- 2022/07/12 06:01 [medline]
PHST- 2022/06/01 00:00 [pmc-release]
AID - jtd-14-06-1922 [pii]
AID - 10.21037/jtd-21-1734 [doi]
PST - ppublish
SO  - J Thorac Dis. 2022 Jun;14(6):1922-1932. doi: 10.21037/jtd-21-1734.