Introduction: Sarcopenia is associated with COPD and emphysema severity. Relief of hyperinflation is achieved via endobronchial valve (EBV) insertion and is usually accompanied by improvements in lung function, symptoms and exercise capacity. However, there is little data concerning EBV impact on skeletal muscle function and strength. We speculate that EBV could improve muscle parameters.

Methods: We conducted a prospective monocentric evaluation of patients treated with EBV between march 2021 and november 2022. Primary outcome was the 3-months change in skeletal muscle mass assessed on bioelectrical impedance analysis, appendicular skeletal muscle mass index (ASMI), muscle surface and density on CT scans (psoas, 5th intercostal, pectoralis, erector spinae). Forced expiratory volume in 1 second (FEV1), residual volume (RV), COPD assessment test (CAT), modified Medical Research Council Dyspnea Scale (mMRC), 6-min walking test (6MWD) were also measured. Sarcopenia was defined following EWGOPS2 guidelines: ASMI <7kg/m² for men and <5,5 kg/m² for women.

Results: We included 21 consecutive subjects who had mean FEV1 34 ± 8%, RV 229 ± 46%, DLCO 24 ± 17%. Three patients out of 18 were considered sarcopenic.
Consistently with published data, there was significant decrease at 3 months in RV -43 % [-68; -17], improvement of FEV1 + 7,3 % [-0.5; 12.5], mMRC -0.5 pts [0; 1]. Target lobe atelectasis was achieved in 13 patients. ASMI significantly improved at 3 months (7.2 ± 2 kg/m² vs 8.5 ± 2 kg/m²) as well as pectoralis density (23.5 ± 17 UH vs 23.6 ± 13.4 UH).

Conclusion: Aside from lung function parameters optimization, EBV could lead to muscle mass improvement and contribute to the global management of emphysema.