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13 results on '"van der Molen, Marieke C."'

4. Impact and timing of pulmonary rehabilitation in patients undergoing bronchoscopic lung volume reduction with endobronchial valves: A multicentre randomized controlled trial in patients with severe emphysema.

Author

van der Molen, Marieke C., Posthuma, Rein, Hartman, Jorine E., van der Vaart, Hester, bij de Vaate, Eline, Vaes, Anouk W., van den Borst, Bram, van Ranst, Dirk, Spruit, Martijn A., Vanfleteren, Lowie E. G. W., Slebos, Dirk‐Jan, van Dijk, Marlies, Koster, T. David, Klooster, Karin, Augustijn, Sonja W.S., and Walraven, Kim H.M.

Subjects
*LUNG volume, *RANDOMIZED controlled trials, *PEDOMETERS, *CHRONIC obstructive pulmonary disease, *VALVES, *REHABILITATION
Abstract

Background and Objective: Both bronchoscopic lung volume reduction with endobronchial valves (BLVR‐EBV) and pulmonary rehabilitation (PR) are effective treatments for improving exercise capacity and patient‐reported outcomes in patients with severe Chronic Obstructive Pulmonary Disease (COPD). According to current recommendations, all BLVR‐EBV patients should have undergone PR first. Our aim was to study the effects of PR both before and after BLVR‐EBV compared to BLVR‐EBV alone. Methods: We included patients with severe COPD who were eligible for BLVR‐EBV and PR. Participants were randomized into three groups: PR before BLVR‐EBV, PR after BLVR‐EBV or BLVR‐EBV without PR. The primary outcome was change in constant work rate cycle test (CWRT) endurance time at 6‐month follow‐up of the PR groups compared to BLVR‐EBV alone. Secondary endpoints included changes in 6‐minute walking test, daily step count, dyspnoea and health‐related quality of life. Results: Ninety‐seven participants were included. At 6‐month follow‐up, there was no difference in change in CWRT endurance time between the PR before BLVR‐EBV and BLVR‐EBV alone groups (median: 421 [IQR: 44; 1304] vs. 787 [123; 1024] seconds, p = 0.82) or in any of the secondary endpoints, but the PR after BLVR‐EBV group exhibited a smaller improvement in CWRT endurance time (median: 107 [IQR: 2; 573], p = 0.04) and health‐related quality of life compared to BLVR‐EBV alone. Conclusion: The addition of PR to BLVR‐EBV did not result in increased exercise capacity, daily step count or improved patient‐reported outcomes compared to BLVR‐EBV alone, neither when PR was administered before BLVR‐EBV nor when PR was administered after BLVR‐EBV. Our findings suggest that a combination of pulmonary rehabilitation and bronchoscopic lung volume reduction with endobronchial valves (BLVR‐EBV) may not provide additional benefits compared to BLVR‐EBV alone at a group‐level. Future challenges lie in selecting patients for whom a combined rehabilitation trajectory would be beneficial. See relatededitorial [ABSTRACT FROM AUTHOR]

Published
2024
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7. Late Breaking Abstract - The impact and timing of pulmonary rehabilitation in patients undergoing bronchoscopic lung volume reduction with endobronchial valves: a randomized controlled trial in patients with severe emphysema

Author

Van Der Molen, Marieke C., primary, Posthuma, Rein, additional, Hartman, Jorine E., additional, Van Der Vaart, Hester, additional, Bij De Vaate, Eline, additional, Vaes, Anouk W., additional, Van Der Borst, Bram, additional, Van Ranst, Dirk, additional, Spruit, Martijn A., additional, Vanfleteren, Lowie E.G.W., additional, and Slebos, Dirk-Jan, additional

Published
2023
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8. Reduction of Lung Hyperinflation Improves Cardiac Preload, Contractility, and Output in Emphysema: A Prospective Cardiac Magnetic Resonance Study in Patients Who Received Endobronchial Valves

Author

van der Molen, Marieke C, Hartman, Jorine E, Vanfleteren, Lowie E G W, Kerstjens, Huib A M, van Melle, Joost P, Willems, Tineke P, Slebos, Dirk-Jan, Groningen Research Institute for Asthma and COPD (GRIAC), Cardiovascular Centre (CVC), and ​Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE)

Abstract

RATIONALE: Pulmonary hyperinflation in patients with Chronic Obstructive Pulmonary Disease (COPD) has been related to smaller cardiac chamber sizes and impaired cardiac function. Nowadays, bronchoscopic lung volume reduction (BLVR) with endobronchial valves is a treatment option to reduce pulmonary hyperinflation in patients with severe emphysema. OBJECTIVES: We hypothesized that reduction of hyperinflation would improve cardiac preload in this patient group. In addition, we investigated whether the treatment would result in elevated pulmonary artery pressures due to pulmonary vascular bed reduction. METHODS: We included patients with emphysema and severe hyperinflation (defined by a baseline residual volume >175% of predicted) who were eligible for BLVR with endobronchial valves. Cardiac magnetic resonance imaging was obtained one day prior to treatment and at eight week follow-up. Primary endpoint was cardiac preload, as measured by the right ventricle end-diastolic volume index (RVEDVI). As secondary endpoints, we measured indexed end-diastolic and end-systolic volumes of the right ventricle, left atrium, and left ventricle, pulmonary artery pressures, cardiac output, ejection fraction, and strain. MEASUREMENTS AND MAIN RESULTS: Twenty-four patients were included. At eight week follow-up, RVEDVI was significantly improved (+7.9 ml/m2, SD 10.0, p=0.001). In addition to increased stroke volumes, we found significantly higher ejection fractions and strain measurements. Although cardiac output was significantly increased (+0.9L/min, SD 1.5, p=0.007), there were no changes in pulmonary artery pressures. CONCLUSIONS: We found that reduction of hyperinflation using BLVR with endobronchial valves significantly improved cardiac preload, myocardial contractility, and cardiac output, without changes in pulmonary artery pressures. Clinical trial registered with ClinicalTrials.gov (NCT03474471).

Published
2022

10. Determinants of Lung Fissure Completeness

Author

van der Molen, Marieke C., primary, Hartman, Jorine E., additional, Vermeulen, Cornelis J., additional, van den Berge, Maarten, additional, Faiz, Alen, additional, Kerstjens, Huib A. M., additional, Charbonnier, Jean-Paul, additional, Vanfleteren, Lowie E. G. W., additional, and Slebos, Dirk-Jan, additional

Published
2021
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