1. Cardio-Pulmonary Changes After Bronchoscopic Lung Volume Reduction with Endobronchial One-Way Valves
- Author
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Camilla Vanni, Roberto Cascone, Mario Santini, Claudio Andreetti, Alfonso Fiorelli, Federico Venuta, Valentina Peritore, Erino A. Rendina, Camilla Poggi, Giovanni Natale, Fiorelli, A., Cascone, R., Natale, G., Peritore, V., Vanni, C., Poggi, C., Venuta, F., Rendina, E. A., Santini, M., and Andreetti, C.
- Subjects
Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Bronchoscopic lung volume reduction ,Hemodynamics ,Heterogeneous emphysema ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine.artery ,Forced Expiratory Volume ,Surveys and Questionnaires ,Bronchoscopy ,medicine ,Volume reduction ,Humans ,030212 general & internal medicine ,Respiratory system ,Pneumonectomy ,Aged ,Retrospective Studies ,business.industry ,Endobronchial one-way valve ,Cardio-pulmonary function ,Stroke volume ,medicine.disease ,Pulmonary hypertension ,Residual Volume ,medicine.anatomical_structure ,Treatment Outcome ,030228 respiratory system ,Pulmonary Emphysema ,Ventricle ,Pulmonary artery ,Cardiology ,Female ,Hemodynamics change ,business ,Lung Volume Measurements ,Tomography, X-Ray Computed - 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 ≥ 563mL (n = 50) presented a significant improvement of forced expiratory volume in one second, residual volume, 6min-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 6min-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.
- Published
- 2020