Introduction
Data on efficacy and safety of endoscopic lung volume reduction (ELVR) with valves in patients with severe lung emphysema and a very-low 6 minute walk test (6MWT) is lacking. The aim was to compare outcome and complications after ELVR with valves in patients with very-low 6-minute walk distance (6MWD?140m) to patients with low 6MWD (140-450m) at baseline.
Method
All data derived from the German Lung Emphysema Registry (Lungenemphysem Register e.V.); a multi-center prospective observational study to assess outcome and safety of ELVR. 19 patients with 6MWD?140m and 108 patients with 6MWD 140-450m at baseline were compared in regard to lung function (FEV1, RV), SGRQ, CAT and 6MWD.
Results
Baseline parameters were similar in both groups except for lower scores of SGRQ and CAT (p<0.05 all) in patients with 6MWD?140m. Compared to baseline, both groups showed significant improvements of FEV1, RV, 6MWD, CAT and SGRQ during FU (all p<0.05). Interestingly, in direct comparison, 6MWD increased more in patients with 6MWD?140m compared to patients with 6MWD 140-450m (table 1). Occurrence of adverse events were similar in both groups.
|
6-MWD?140m n=19 |
6-MWD>140-450m n=108 |
p-value | |
| ?FEV1 (L) | 0.1±0.2 | 0.1±0.2 | 0.9 |
| ?RV (L) | -0.7±1.1 | -0.7±1.2 | 0.8 |
| ?6MWD (m) | 114.3±113.1 | 26.0±90.8 | 0.01 |
| ?CAT (points) | -1.6±5.7 | -2.1±6.5 | 0.8 |
| ?SGRQ (points) | -4.4±10.9 | -6.8±15.3 | 0.7 |
Conclusion
ELVR is an efficient and safe treatment option even in selected patients with severe emphysema and a very-low 6MWD. In contrast to lung volume reduction surgery, the data suggest that 6MWD of less than 140 m does not appear to be an exclusion criterion for ELVR.