The following is a summary of “Improved exercise capacity results in a survival benefit after endobronchial valve treatment,” published in the APRIL 2023 issue of Pulmonology by Roodenburg, et al.
Using endobronchial valves (EBV) for bronchoscopic lung volume reduction effectively improves pulmonary function, exercise capacity, and quality of life for patients with advanced emphysema. For a study, researchers sought to determine whether the treatment response to EBV significantly influenced survival time.
The study evaluated the treatment response at 6-week and 1-year follow-ups of all patients treated with EBVs between 2008 and 2020, and the survival status was retrieved on December 1, 2021. Patients were defined as responders or non-responders based on minimal important differences for several factors, including FEV1, residual volume (RV), RV/Total Lung Capacity (TLC) ratio, 6-minute walk distance (6MWD), St. George’s Respiratory Questionnaire (SGRQ), target lobe volume reduction (TLVR), and complete lobar atelectasis.
The study included 428 patients, and the results showed that EBV treatment significantly improved pulmonary function, exercise capacity, and quality of life. The median survival time after treatment was 8.2 years. The study also found that the improvement in exercise capacity and quality of life, as measured by SGRQ and 6MWD response, were independent predictors for improved survival time (Hazard Ratio (HR) 0.50 [0.28–0.89], P= .02 and HR 0.54 [0.30–0.94], P = .03, respectively). Complete lobar atelectasis did not significantly affect survival nor improve pulmonary function.
In conclusion, the study suggested that improving exercise capacity and quality of life after EBV treatment was associated with a survival benefit independent of improvements in pulmonary function, reduction in target lobe volume, or complete lobar atelectasis. This finding highlighted the importance of monitoring and addressing non-pulmonary factors, such as quality of life, in the management of patients with advanced emphysema.