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Cardio-Pulmonary Changes After Bronchoscopic Lung Volume Reduction with Endobronchial One-Way Valves

  • LUNG VOLUME REDUCTION
  • Published:
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Abstract

Introduction

To evaluate the cardio-pulmonary hemodynamics changes before and after valve treatment, and their correlation with lobe volume reduction.

Methods

This retrospective multicentre study included consecutive patients undergoing bronchoscopic valve treatment for heterogeneous emphysema. In addition to standard functional evaluation, patients underwent cardiac evaluation by Doppler trans-thoracic echocardiography. The difference in respiratory and cardio-pulmonary hemodynamics indexes before and 3-month after the procedure, and their relationship with changes in lobar volume were evaluated.

Results

Seventy-seven patients were included in the study; of these 13 (17%) presented pulmonary hypertension. Only patients with target lobar volume reduction ≥ 563 mL (n = 50) presented a significant improvement of forced expiratory volume in one second, residual volume, 6 min-walk test, and St. George’s Respiratory Questionnaire score; a significant reduction of pulmonary artery pressure, and an improvement of left and right ventricle end-systolic volume; of left and right ventricle end-diastolic volume, and of left and right ventricle stroke volume. The change in residual volume was significantly correlated with changes in forced expiratory volume in one second (r = 0.68; p < 0.001); in 6 min-walk test (r = 0.71; p < 0.001); in St. George’s Respiratory Questionnaire (r = 0.54; p < 0.001); in pulmonary artery pressure (r = 0.39; p = 0.001), in left (r = 0.28; p = 0.01) and right (r = 0.33; p = 0.002) ventricle end-systolic volume, in left (r =  − 0.29; p = 0.008) and right (r =  − 0.34; p = 0.007) end-diastolic volume, and in left (r =  − 0.76; p = 0.009) and right (r =  − 0.718; p = 0.001) ventricle stroke volume.

Conclusion

Bronchoscopic valve treatment seemed to have positive effects on cardio-pulmonary hemodynamics, and these changes were correlated with reductions of lobar volume.

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Authors and Affiliations

  1. Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, Caserta, Italy

    Alfonso Fiorelli, Roberto Cascone, Giovanni Natale & Mario Santini

  2. Thoracic Surgery Unit, Sant’Andrea Hospital, University of Rome La Sapienza, Rome, Italy

    Valentina Peritore, Camilla Vanni, Erino Angelo Rendina & Claudio Andreetti

  3. Thoracic Surgery Unit, Policlinico Hospital, University of Rome La Sapienza, Rome, Italy

    Camilla Poggi & Federico Venuta

Authors
  1. Alfonso Fiorelli
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  2. Roberto Cascone
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  3. Giovanni Natale
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  4. Valentina Peritore
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  5. Camilla Vanni
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  6. Camilla Poggi
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  7. Federico Venuta
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  8. Erino Angelo Rendina
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  9. Mario Santini
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  10. Claudio Andreetti
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Correspondence to Alfonso Fiorelli.

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Conflict of interest

Alfonso Fiorelli, Roberto Cascone, Giovanni Natale, Valentina Peritore, Camilla Vanni, Camilla Poggi, Federico Venuta, Erino Angelo Rendina, Mario Santini, and Claudio Andreetti disclose no conflict of interest and no funding for the present paper.

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Fiorelli, A., Cascone, R., Natale, G. et al. Cardio-Pulmonary Changes After Bronchoscopic Lung Volume Reduction with Endobronchial One-Way Valves. Lung 198, 565–573 (2020). https://doi.org/10.1007/s00408-020-00351-4

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  • DOI: https://doi.org/10.1007/s00408-020-00351-4

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