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Long-term follow up after endoscopic valve therapy in patients with severe emphysema

BACKGROUND AND OBJECTIVE: Endoscopic valve therapy is a treatment modality in patients with advanced emphysema and absent interlobar collateral ventilation (CV). So far, long-term outcome following valve implantation has been insufficiently evaluated. The aim of this study was to investigate the rea...

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Autores principales: Gompelmann, Daniela, Heinhold, Tobias, Rötting, Matthias, Bischoff, Elena, Kontogianni, Konstantina, Eberhardt, Ralf, Herth, Felix J. F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6681249/
https://www.ncbi.nlm.nih.gov/pubmed/31373259
http://dx.doi.org/10.1177/1753466619866101
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author Gompelmann, Daniela
Heinhold, Tobias
Rötting, Matthias
Bischoff, Elena
Kontogianni, Konstantina
Eberhardt, Ralf
Herth, Felix J. F.
author_facet Gompelmann, Daniela
Heinhold, Tobias
Rötting, Matthias
Bischoff, Elena
Kontogianni, Konstantina
Eberhardt, Ralf
Herth, Felix J. F.
author_sort Gompelmann, Daniela
collection PubMed
description BACKGROUND AND OBJECTIVE: Endoscopic valve therapy is a treatment modality in patients with advanced emphysema and absent interlobar collateral ventilation (CV). So far, long-term outcome following valve implantation has been insufficiently evaluated. The aim of this study was to investigate the real-world efficacy of this interventional therapy over 3 years. METHODS: From 2006 to 2013, 256 patients with severe emphysema in whom absent CV was confirmed underwent valve therapy. The 3-year effectiveness was evaluated by pulmonary function testing (VC, FEV(1), RV, TLC), 6-minute-walk test (6-MWT) and dyspnea questionnaire (mMRC). Long-term outcome was also assessed according to the radiological outcome following valve placement. RESULTS: Of 256 patients treated with valves, 220, 200, 187, 100 and 66 patients completed the 3-month, 6-month, 1-year, 2-year and 3-year follow-up (FU) visit, respectively. All lung function parameters, 6-MWT and mMRC were significantly improved at 3- and 6-month FU. At 1-year FU, patients still experienced a significant improvement of all outcome parameters expect VC (L) and TLC (%). At 2 years, RV (L and %) and TLC (L and %) remained significantly improved compared to baseline. Three years after valve therapy, sustained significant improvement in mMRC was observed and the proportion of patients achieving a minimal clinically important difference from baseline in RV and 6-MWT was still 71% and 46%, respectively. Overall, patients with complete lobar atelectasis exhibited superior treatment outcome with 3-year responder rates to FEV(1), RV and 6-MWT of 10%, 79% and 53%, respectively. CONCLUSIONS: Patients treated by valves experienced clinical improvement over 1 year following valve therapy. Afterwards, clinical benefit gradually declines more likely due to COPD progression.
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spelling pubmed-66812492019-08-19 Long-term follow up after endoscopic valve therapy in patients with severe emphysema Gompelmann, Daniela Heinhold, Tobias Rötting, Matthias Bischoff, Elena Kontogianni, Konstantina Eberhardt, Ralf Herth, Felix J. F. Ther Adv Respir Dis Original Research BACKGROUND AND OBJECTIVE: Endoscopic valve therapy is a treatment modality in patients with advanced emphysema and absent interlobar collateral ventilation (CV). So far, long-term outcome following valve implantation has been insufficiently evaluated. The aim of this study was to investigate the real-world efficacy of this interventional therapy over 3 years. METHODS: From 2006 to 2013, 256 patients with severe emphysema in whom absent CV was confirmed underwent valve therapy. The 3-year effectiveness was evaluated by pulmonary function testing (VC, FEV(1), RV, TLC), 6-minute-walk test (6-MWT) and dyspnea questionnaire (mMRC). Long-term outcome was also assessed according to the radiological outcome following valve placement. RESULTS: Of 256 patients treated with valves, 220, 200, 187, 100 and 66 patients completed the 3-month, 6-month, 1-year, 2-year and 3-year follow-up (FU) visit, respectively. All lung function parameters, 6-MWT and mMRC were significantly improved at 3- and 6-month FU. At 1-year FU, patients still experienced a significant improvement of all outcome parameters expect VC (L) and TLC (%). At 2 years, RV (L and %) and TLC (L and %) remained significantly improved compared to baseline. Three years after valve therapy, sustained significant improvement in mMRC was observed and the proportion of patients achieving a minimal clinically important difference from baseline in RV and 6-MWT was still 71% and 46%, respectively. Overall, patients with complete lobar atelectasis exhibited superior treatment outcome with 3-year responder rates to FEV(1), RV and 6-MWT of 10%, 79% and 53%, respectively. CONCLUSIONS: Patients treated by valves experienced clinical improvement over 1 year following valve therapy. Afterwards, clinical benefit gradually declines more likely due to COPD progression. SAGE Publications 2019-08-02 /pmc/articles/PMC6681249/ /pubmed/31373259 http://dx.doi.org/10.1177/1753466619866101 Text en © The Author(s), 2019 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
Gompelmann, Daniela
Heinhold, Tobias
Rötting, Matthias
Bischoff, Elena
Kontogianni, Konstantina
Eberhardt, Ralf
Herth, Felix J. F.
Long-term follow up after endoscopic valve therapy in patients with severe emphysema
title Long-term follow up after endoscopic valve therapy in patients with severe emphysema
title_full Long-term follow up after endoscopic valve therapy in patients with severe emphysema
title_fullStr Long-term follow up after endoscopic valve therapy in patients with severe emphysema
title_full_unstemmed Long-term follow up after endoscopic valve therapy in patients with severe emphysema
title_short Long-term follow up after endoscopic valve therapy in patients with severe emphysema
title_sort long-term follow up after endoscopic valve therapy in patients with severe emphysema
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6681249/
https://www.ncbi.nlm.nih.gov/pubmed/31373259
http://dx.doi.org/10.1177/1753466619866101
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